Provider Demographics
NPI:1619603321
Name:WHITNEY, KRISTEN (APRN)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-4087
Mailing Address - Country:US
Mailing Address - Phone:207-962-1200
Mailing Address - Fax:
Practice Address - Street 1:69 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-4087
Practice Address - Country:US
Practice Address - Phone:207-962-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology