Healthcare Provider Details

I. General information

NPI: 1245070184
Provider Name (Legal Business Name): KELLY K FINLAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 NORTH ST
WATERVILLE ME
04901-4974
US

IV. Provider business mailing address

149 NORTH ST
WATERVILLE ME
04901-4974
US

V. Phone/Fax

Practice location:
  • Phone: 207-861-6500
  • Fax: 207-861-6534
Mailing address:
  • Phone: 207-861-6500
  • Fax: 207-861-6534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3179
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: