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Individual

KRISTY M SURPRISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
ONE MEDICAL CENTER DRIVE, BIDDEFORD, ME 04005
(207) 283-7000
(207) 283-7275
Mailing address
ONE MEDICAL CENTER DRIVE, BIDDEFORD, ME 04005
(207) 283-7000
(207) 283-7275

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP81940
ME
363LA2200X
Adult Health Nurse Practitioner
Primary
CNP81940
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30347565
NH
05
433351099
ME
Enumeration date
09/03/2008
Last updated
04/16/2019
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