Individual
KRISTIE A IACUESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
163 MAIN ST, YARMOUTH, ME 04096-6720
(207) 846-1380
(207) 846-9701
Mailing address
163 MAIN ST, YARMOUTH, ME 04096-6720
(207) 846-1380
(207) 846-9701
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
AP1251, DL20000389
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060404
BLUE CROSS
ME
05
—
274460099
—
ME
01
—
3207069
AETNA
ME
Enumeration date
11/20/2006
Last updated
08/17/2010
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