Individual
KATHY BOUTON SEMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
21 WESTERN AVE, HAMPDEN, ME 04444-1422
(207) 862-0300
(207) 907-1041
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8560
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1051
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300640099
—
ME
Enumeration date
08/05/2006
Last updated
02/03/2022
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