Healthcare Provider Details

I. General information

NPI: 1043919038
Provider Name (Legal Business Name): KRISTINA BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 MAIN ST
CHERRYFIELD ME
04622-4211
US

IV. Provider business mailing address

217 WATER ST
ADDISON ME
04606-3027
US

V. Phone/Fax

Practice location:
  • Phone: 207-598-8499
  • Fax:
Mailing address:
  • Phone: 207-598-8499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP231025
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP231025
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: