Provider Demographics
NPI:1467650457
Name:KITTREDGE, PATRICIA ARLENE (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ARLENE
Last Name:KITTREDGE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ARLENE
Other - Last Name:HUTCHINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-0304
Mailing Address - Country:US
Mailing Address - Phone:207-657-1165
Mailing Address - Fax:207-657-1162
Practice Address - Street 1:6 TURNPIKE ACRES RD STE 2
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-9432
Practice Address - Country:US
Practice Address - Phone:207-657-1165
Practice Address - Fax:207-657-1162
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP91009363LF0000X
MECNP091009363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000205202Medicare PIN