Healthcare Provider Details
I. General information
NPI: 1639821978
Provider Name (Legal Business Name): KAYLA MARIE FLAHERTY NP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/18/2022
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 FIRST PARK DR
OAKLAND ME
04963-5369
US
IV. Provider business mailing address
25 FIRST PARK DR
OAKLAND ME
04963-5369
US
V. Phone/Fax
- Phone: 207-465-2181
- Fax: 207-465-4629
- Phone: 207-465-2181
- Fax: 207-465-4629
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | CNP211627 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: