| NPI | 1003633694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER KENNEDY Authorized Official 207-807-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2025-08-05 |