Healthcare Provider Details

I. General information

NPI: 1841584588
Provider Name (Legal Business Name): LEDA KATHRYN WERRELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2011
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 PINELAND DR STE 102
NEW GLOUCESTER ME
04260-5141
US

IV. Provider business mailing address

119 VILLAGE VIEW LN
NORTH YARMOUTH ME
04097-6352
US

V. Phone/Fax

Practice location:
  • Phone: 207-306-2964
  • Fax: 207-200-1251
Mailing address:
  • Phone: 406-218-9066
  • Fax: 207-200-1251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP191306
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: