Individual
KATHLEEN VIRGINIA LONERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-4630
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-4630
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
027368
NY
363A00000X
Physician Assistant
PA2921
ME
363AM0700X
Medical Physician Assistant
0110009039
VA
363AS0400X
Surgical Physician Assistant
Primary
PA2921
ME
Other
Enumeration date
07/16/2021
Last updated
09/23/2025
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