Provider Demographics
NPI:1316594096
Name:BURBINE, KRAIG MICHAEL (RN)
Entity Type:Individual
Prefix:MR
First Name:KRAIG
Middle Name:MICHAEL
Last Name:BURBINE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WALTER ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6231
Mailing Address - Country:US
Mailing Address - Phone:207-852-4756
Mailing Address - Fax:
Practice Address - Street 1:118 MOOSEHEAD TRL STE 5
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:ME
Practice Address - Zip Code:04953-4056
Practice Address - Country:US
Practice Address - Phone:207-368-5189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN72370163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management