Healthcare Provider Details

I. General information

NPI: 1366532699
Provider Name (Legal Business Name): MICHAEL GIRARD KAPINOS CRNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 MAINE ST
BRUNSWICK ME
04011-3310
US

IV. Provider business mailing address

360 SEARSMONT RD
APPLETON ME
04862-6403
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-2250
  • Fax:
Mailing address:
  • Phone: 207-706-6621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberE36889
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberR020505
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: