Provider Demographics
NPI:1083644637
Name:RAMSDELL, KELLIE J (MSN)
Entity Type:Individual
Prefix:
First Name:KELLIE
Middle Name:J
Last Name:RAMSDELL
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MARQUIS RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6477
Mailing Address - Country:US
Mailing Address - Phone:207-865-6131
Mailing Address - Fax:207-865-9399
Practice Address - Street 1:50 MARQUIS RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-6477
Practice Address - Country:US
Practice Address - Phone:207-865-6131
Practice Address - Fax:207-865-9399
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER045704163WG0000X
MECNP81066363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice