Healthcare Provider Details

I. General information

NPI: 1306756176
Provider Name (Legal Business Name): MEGAN KIMBALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 HIGH WATCH RD
EFFINGHAM NH
03882-8336
US

IV. Provider business mailing address

37 SHORE RD
GRAY ME
04039-5404
US

V. Phone/Fax

Practice location:
  • Phone: 866-652-8889
  • Fax:
Mailing address:
  • Phone: 866-652-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP251493
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number118852-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: