Healthcare Provider Details

I. General information

NPI: 1124994819
Provider Name (Legal Business Name): KRISTIN SEELEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL LN
CALAIS ME
04619-1329
US

IV. Provider business mailing address

629 S EDMUNDS RD
EDMUNDS TWP ME
04628-5515
US

V. Phone/Fax

Practice location:
  • Phone: 207-454-7521
  • Fax:
Mailing address:
  • Phone: 207-454-7521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN85210
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: