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Individual

KATHLEEN DOLAN EMERSON EMERDELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM, WHNP, RN

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
(510) 300-8039
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95048259
CA
163W00000X
Registered Nurse
RN80303
ME
363LW0102X
Women's Health Nurse Practitioner
95005404
CA
367A00000X
Advanced Practice Midwife
235826
CA
367A00000X
Advanced Practice Midwife
Primary
CNM212013
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CNM03965
CNM03965
ME
Enumeration date
11/23/2016
Last updated
05/12/2022
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