KRISTEN M ELLENSOHN APRN FNP NPI 1689618563

NPI Information

NPI: 1689618563
Provider Name: KRISTEN M ELLENSOHN, APRN FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
144 STATE ST
PORTLAND, ME
ZIP 04101
Phone: (207) 400-8500
Get Directions

Kristen M Ellensohn, APRN FNP is a family nurse practitioner in Portland, ME. Kristen M Ellensohn, APRN FNP NPI is 1689618563. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

144 STATE ST
PORTLAND, ME
ZIP 04101-776
Phone: (207) 400-8500
Fax: (207) 400-8508

The NPI 1689618563 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 2/26/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	CNP141022	MAINE	No
2	363LF0000X	Nurse Practitioner	Family	209004972	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CNP141022	MEDICAID	MAINE
2	209004972	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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