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Individual

KELLY LYNN CIGNOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
165 LANCASTER STREET, PORTLAND, ME 04101-2406
(207) 874-1030
(207) 874-1044
Mailing address
78 ATLANTIC PLACE, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN46427
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP81885
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432891599
ME
Enumeration date
02/18/2008
Last updated
10/12/2012
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