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NPI Code Detail

MEDICARE: EKATERINA FUNK CNP

MEDICARE:   EKATERINA  FUNK  CNP
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
1363LF0000XFamily Nurse PractitionerCNP141064ME

General Provider Information

NPI Number : 1376950337
Entity Type Code : Individual
Provider Name (Legal Business Name) : EKATERINA FUNK CNP
Provider Business Mailing Address
First Line : 100 CAMPUS DR
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7171
Country : US
Telephone Number : 207-396-7683
Fax Number : 207-396-7684
Provider Business Practice Location Address
First Line : 100 CAMPUS DR
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7171
Country : US
Telephone Number : 207-396-7683
Fax Number : 207-396-7684
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2014
Last Update Date : 06/07/2022

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