MEDICARE: KRISTEN MARIA MARTIN ANPBC

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
1	163WR0006X	Registered Nurse First Assistant	RN39487	ME
2	363LA2200X	Adult Health Nurse Practitioner	CNP81798	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386740348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN MARIA MARTIN ANPBC

Provider Business Mailing Address
First Line	:	300 PROFESSIONAL DR STE 2B
Second Line	:
City	:	SCARBOROUGH
State	:	ME
Zip	:	04074-8897
Country	:	US
Telephone Number	:	207-761-1502
Fax Number	:	207-774-2015

Provider Business Practice Location Address
First Line	:	300 PROFESSIONAL DR STE 2B
Second Line	:
City	:	SCARBOROUGH
State	:	ME
Zip	:	04074-8897
Country	:	US
Telephone Number	:	207-761-1502
Fax Number	:	207-774-2015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	11/12/2025

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Directions to “ KRISTEN MARIA MARTIN ANPBC” Practice Location

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