Provider Demographics
NPI:1891226221
Name:ARSENAULT, KRISTIN
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:ARSENAULT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 RAILROAD ST
Mailing Address - Street 2:PO BOX 1367
Mailing Address - City:BETHEL
Mailing Address - State:ME
Mailing Address - Zip Code:04217-1367
Mailing Address - Country:US
Mailing Address - Phone:207-824-2193
Mailing Address - Fax:207-824-3005
Practice Address - Street 1:32 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:ME
Practice Address - Zip Code:04217-1367
Practice Address - Country:US
Practice Address - Phone:207-824-2193
Practice Address - Fax:207-824-3005
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP171029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily