Individual
KELSEY ELIZABETH WENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Mailing address
175 FORE RIVER PKWY, PORTLAND, ME 04102-2779
(802) 279-4609
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/18/2018
Last updated
12/11/2024
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