Individual
KELLY WALDROUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
582 ROOSEVELT TRL, WINDHAM, ME 04062-4904
(207) 892-3233
Mailing address
582 ROOSEVELT TRL, WINDHAM, ME 04062-4904
(207) 892-3233
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP211586
ME
Other
Enumeration date
12/31/2021
Last updated
12/31/2021
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