Individual
KIMBERLY A NEVELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1420 MAIN ST, SANFORD, ME 04073-3680
(207) 850-5744
Mailing address
360 US HIGHWAY 1 BYP UNIT 102, PORTSMOUTH, NH 03801-7105
(603) 410-6700
(603) 319-8308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0390656
ME
363L00000X
Nurse Practitioner
CNP81440
ME
363LF0000X
Family Nurse Practitioner
Primary
CNP81440
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508840091
—
ME
Enumeration date
11/30/2005
Last updated
01/25/2024
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