Healthcare Provider Details

I. General information

NPI: 1902725732
Provider Name (Legal Business Name): CATHLEEN GRACE KNUDSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 NAHUM JONES RD
GOULDSBORO ME
04607-3029
US

IV. Provider business mailing address

14 NAHUM JONES RD
GOULDSBORO ME
04607-3029
US

V. Phone/Fax

Practice location:
  • Phone: 207-460-1928
  • Fax:
Mailing address:
  • Phone: 207-460-1928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCNA9772
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: