MEDICARE: PATRICIA ARLENE KITTREDGE FNP

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	363LF0000X	Family Nurse Practitioner	CNP91009	ME
2	363LA2200X	Adult Health Nurse Practitioner	CNP091009	ME

General Provider Information

NPI Number	:	1467650457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ARLENE KITTREDGE FNP

Provider Business Mailing Address
First Line	:	PO BOX 304
Second Line	:
City	:	GRAY
State	:	ME
Zip	:	04039-0304
Country	:	US
Telephone Number	:	207-657-1165
Fax Number	:	207-657-1162

Provider Business Practice Location Address
First Line	:	6 TURNPIKE ACRES RD STE 2
Second Line	:
City	:	GRAY
State	:	ME
Zip	:	04039-9432
Country	:	US
Telephone Number	:	207-657-1165
Fax Number	:	207-657-1162

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	07/17/2023

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