Healthcare Provider Details

I. General information

NPI: 1891226221
Provider Name (Legal Business Name): KRISTIN ARSENAULT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 RAILROAD ST
BETHEL ME
04217-1367
US

IV. Provider business mailing address

32 RAILROAD ST PO BOX 1367
BETHEL ME
04217-1367
US

V. Phone/Fax

Practice location:
  • Phone: 207-824-2193
  • Fax: 207-824-3005
Mailing address:
  • Phone: 207-824-2193
  • Fax: 207-824-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP171029
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: