Fantasia, Kimberley R
Fantasia, Kimberley R is an individual health care provider with primary practice located at 200 Kennedy Memorial Dr , Waterville ME 04901-4526. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fantasia, Kimberley R can be contacted via phone (207) 681-3000.Contact Information
Primary practice address
200 Kennedy Memorial Dr
Waterville ME 04901-4526
Phone: (207) 681-3000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R051730 | Maine |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP081842 | Maine |
Profile Details
| NPI number | 1154547479 |
|---|---|
| LBN Legal business name | Fantasia, Kimberley R |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2007 |
| Last updated | Sep 2nd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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