Provider Demographics
NPI:1255338968
Name:MORIN, KRISTZINA L (DO)
Entity type:Individual
Prefix:
First Name:KRISTZINA
Middle Name:L
Last Name:MORIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04643-3043
Mailing Address - Country:US
Mailing Address - Phone:207-483-4502
Mailing Address - Fax:207-483-4778
Practice Address - Street 1:50 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04643-3043
Practice Address - Country:US
Practice Address - Phone:207-483-4502
Practice Address - Fax:207-483-4778
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME00609207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MED33624Medicare UPIN
MEMM0091Medicare ID - Type Unspecified