Healthcare Provider Details

I. General information

NPI: 1558440636
Provider Name (Legal Business Name): KIMBERLY R COMPARETTO APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HEALTHCARE DRIVE SUITE 101
BIDDEFORD ME
04005
US

IV. Provider business mailing address

1 MEDICAL CENTER DRIVE
BIDDEFORD ME
04005
US

V. Phone/Fax

Practice location:
  • Phone: 207-282-4270
  • Fax: 207-282-7350
Mailing address:
  • Phone: 207-282-9080
  • Fax: 207-282-9128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP81172
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN37812
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: