Individual
KRISTEN M ELLENSOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN FNP
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 400-8500
(207) 400-8508
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 400-8500
(207) 400-8508
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209004972
IL
363LF0000X
Family Nurse Practitioner
CNP141022
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209004972
—
IL
05
—
CNP141022
—
ME
Enumeration date
06/15/2006
Last updated
02/26/2015
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