Individual
KENDRA J LEBRETON-GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
417 STATE ST, STE 221, BANGOR, ME 04401-6630
(207) 973-9949
(207) 973-9555
Mailing address
43 WHITING HILL RD, STE 300, BREWER, ME 04412-1005
(207) 973-5035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1444
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432205999
—
ME
Enumeration date
09/13/2006
Last updated
02/21/2014
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