=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700721610
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATELYN M BACHELDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2026
-----------------------------------------------------
Last Update Date | 04/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 672 WILTON RD
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04938-6138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-778-9531
-----------------------------------------------------
Fax | 866-644-5928
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 87 MONTFORT DR
-----------------------------------------------------
City | STRONG
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04983-3031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | RN67581
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------