Healthcare Provider Details

I. General information

NPI: 1083641575
Provider Name (Legal Business Name): KATHRYN M SAUNDERS APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KATAHDIN VALLEY HEALTH CENTER 50 SUMMER STREET
MILLINOCKET ME
04462-1400
US

IV. Provider business mailing address

529 S PATTEN RD
PATTEN ME
04765-3007
US

V. Phone/Fax

Practice location:
  • Phone: 207-538-3700
  • Fax: 207-528-2880
Mailing address:
  • Phone: 207-538-3700
  • Fax: 855-674-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberCNP231213
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number101-0022934
License Number StateVT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierOVN3337
Identifier TypeMEDICAID
Identifier StateVT
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: