Provider Demographics
NPI:1568564086
Name:DOBBINS, KRISTIN J (NP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:J
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:J
Other - Last Name:FORREST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4 GLEN COVE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4235
Mailing Address - Country:US
Mailing Address - Phone:207-593-5800
Mailing Address - Fax:207-593-5332
Practice Address - Street 1:4 GLEN COVE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4235
Practice Address - Country:US
Practice Address - Phone:207-593-5800
Practice Address - Fax:207-593-5332
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER036551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENP2588Medicare ID - Type Unspecified
P12139Medicare UPIN