KRISTEN MICKKELSEN PMHNP BC LLC NPI 1528502002

NPI Information

NPI: 1528502002
Provider Name: KRISTEN MICKKELSEN PMHNP BC LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
1321 WASHINGTON AVE
SUITE 304
PORTLAND, ME
ZIP 04103
Phone: (207) 536-3088
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KRISTEN MICKKELSEN PMHNP BC LLC is a psychiatric/mental health nurse practitioner in Portland, ME. KRISTEN MICKKELSEN PMHNP BC LLC NPI is 1528502002. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1321 WASHINGTON AVE
SUITE 304
PORTLAND, ME
ZIP 04103-636
Phone: (207) 536-3088
Fax: (207) 536-3092

The provider's authorized official is Kristin A Mikkelsen .
The authorized official title is Owner and has the following contact phone number (207) 536-3088.

The enumeration date for this NPI number is 12/19/2016 and was last updated on 12/19/2016.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	CNP121069	MAINE	Yes

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: 11/14/2023

NPI Synchronization or Removal

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