Individual
KASSIE A SKVORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 ACADEMY RD, MONMOUTH, ME 04259-7035
(207) 524-3501
(207) 933-9645
Mailing address
PO BOX 9746, PORTLAND, ME 04104-5040
(207) 791-3888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1648
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316496052
—
ME
Enumeration date
09/22/2016
Last updated
07/21/2022
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