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NPI Code Detail

MEDICARE: DR. KAITLYN ELIZABETH HALSEMA DO

MEDICARE: DR. KAITLYN ELIZABETH HALSEMA DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianDO4165ME
22084P0804XChild & Adolescent Psychiatry PhysicianDO4165ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112761OTHERGARESIDENCY TRAINING PERMIT

General Provider Information

NPI Number : 1033790829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAITLYN ELIZABETH HALSEMA DO
Provider Business Mailing Address
First Line : 6 GLEN COVE DR
Second Line :
City : ROCKPORT
State : ME
Zip : 04856-4272
Country : US
Telephone Number : 207-921-8632
Fax Number : 207-921-5316
Provider Business Practice Location Address
First Line : 6 GLEN COVE DR
Second Line :
City : ROCKPORT
State : ME
Zip : 04856-4272
Country : US
Telephone Number : 207-921-8632
Fax Number : 207-921-5316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2021
Last Update Date : 06/01/2026

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