Provider Demographics
NPI:1376073163
Name:BELADI, KRISTINA J (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:J
Last Name:BELADI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:SEITLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:343 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2006
Mailing Address - Country:US
Mailing Address - Phone:207-772-9800
Mailing Address - Fax:
Practice Address - Street 1:343 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2006
Practice Address - Country:US
Practice Address - Phone:207-772-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP171077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily