Healthcare Provider Details

I. General information

NPI: 1457207367
Provider Name (Legal Business Name): KAYLI CONDON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 BROADWAY ST
BAILEYVILLE ME
04694-3417
US

IV. Provider business mailing address

71 BROADWAY ST
BAILEYVILLE ME
04694-3417
US

V. Phone/Fax

Practice location:
  • Phone: 207-454-9530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP251800
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: