# KRISTINA CHADWICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1265422943
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA631 | ME | Yes |

## Other

- **Enumeration date:** 10/25/2005
- **Last updated:** 09/11/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 010416156 | CIGNA / GREAT WEST | — |
| 01 | — | 025716 | ANTHEM | — |
| 01 | — | 0378600001 | DMERC | — |
| 01 | — | 100294000 | USPS WC | — |
| 01 | — | 1044480 | AETNA | — |
| 01 | — | 201017 | MEDICARE ASC FACILITY | — |
| 05 | — | 261500099 | — | ME |
| 01 | — | 970026374 | RR MEDICARE | — |
| 01 | — | AP1070 | PTAN | — |
| 01 | — | MM0716 | MEDICARE CLINIC FACILITY | — |