Provider Demographics
NPI:1265821607
Name:MORRISROE, KRISTEN WAITT (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:WAITT
Last Name:MORRISROE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:ME
Mailing Address - Zip Code:04001-6403
Mailing Address - Country:US
Mailing Address - Phone:207-604-0422
Mailing Address - Fax:
Practice Address - Street 1:2 LIVEWELL DR
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6762
Practice Address - Country:US
Practice Address - Phone:207-467-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily