Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | CNP151010 | ME |
NPI | 1083007306 |
---|---|
Provider Name | Kimberly Hewitt Spectre |
First Address | Belfast, ME 04915-0226 |
Second Address | Belfast, ME 04915-6009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2015 |
Last Update Date | 11/03/2015 |