Individual
KAITLYN BEVERLY MELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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