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Individual

NICOLE KIPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1 MEDICAL CENTER DR, BIDDEFORD, ME 04005-9422
(207) 294-5783
Mailing address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-5775

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
R043560
ME
367500000X
Certified Registered Nurse Anesthetist
Primary
R043560
ME

Other

Enumeration date
01/09/2009
Last updated
02/07/2024
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