Individual
KATHLEEN INGELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 OAK ST, SPRINGVALE, ME 04083-1926
(207) 490-6900
(207) 459-2822
Mailing address
91 AUBURN ST, STE J #1180, PORTLAND, ME 04103-2119
(203) 577-9660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP221094
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
CNP221094
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2022
Last updated
06/11/2025
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