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Individual

KELLI MEGAN NICOLE HUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
655 MAIN ST, SACO, ME 04072-1699
(207) 294-5600
(207) 294-3565
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2043
363AM0700X
Medical Physician Assistant
4114
CT
363AS0400X
Surgical Physician Assistant
PA2043
ME

Other

Enumeration date
05/11/2018
Last updated
04/11/2024
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