Healthcare Provider Details

I. General information

NPI: 1427658475
Provider Name (Legal Business Name): KELSIE-LYNNE NEWTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 BECKWITH LN
WEST GARDINER ME
04345-3527
US

IV. Provider business mailing address

13 S DONDERO RD
CHELSEA ME
04330-1407
US

V. Phone/Fax

Practice location:
  • Phone: 207-724-2728
  • Fax:
Mailing address:
  • Phone: 207-458-2235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: