Organization
KRISTEN MICKKELSEN PMHNP BC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN A MIKKELSEN PMHNP (OWNER)
(207) 536-3088
Entity
Organization
Contact information
Practice address
1321 WASHINGTON AVE, SUITE 304, PORTLAND, ME 04103-3636
(207) 536-3088
(207) 536-3092
Mailing address
106 SUNSET RD, FALMOUTH, ME 04105-2490
(207) 536-3088
(207) 536-3092
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP121069
ME
Other
Enumeration date
12/19/2016
Last updated
12/19/2016
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