Healthcare Provider Details

I. General information

NPI: 1720795925
Provider Name (Legal Business Name): DR KERRI VACHER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 LINCOLNVILLE AVE
BELFAST ME
04915-6454
US

IV. Provider business mailing address

186 CONGRESS ST
BELFAST ME
04915-6149
US

V. Phone/Fax

Practice location:
  • Phone: 207-322-8922
  • Fax: 833-464-3855
Mailing address:
  • Phone: 207-322-8922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KERRI ANN VACHER
Title or Position: OWNER, PROVIDER
Credential: FNP-C, ND
Phone: 207-322-8922