Healthcare Provider Details

I. General information

NPI: 1437792710
Provider Name (Legal Business Name): KRISTEN MARIE WASKEWICZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN MARIE VAN METER

II. Dates (important events)

Enumeration Date: 10/19/2019
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WHITING HILL RD
BREWER ME
04412-1021
US

IV. Provider business mailing address

43 WHITING HILL RD STE 300
BREWER ME
04412-1006
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7478
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP191229
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: