Provider Demographics
NPI:1689152357
Name:NADEAU, KELSEY ELIZABETH (FNP)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:NADEAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:KELSEY
Other - Middle Name:ELIZABETH
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3102
Mailing Address - Country:US
Mailing Address - Phone:207-768-4457
Mailing Address - Fax:207-768-4456
Practice Address - Street 1:146 ACADEMY ST STE 1B
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3102
Practice Address - Country:US
Practice Address - Phone:207-768-4457
Practice Address - Fax:207-768-4456
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP181184363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily