Wood, Kelleryn V
Wood, Kelleryn V is an individual health care provider with primary practice located at 800 Main St , South Portland ME 04106-6049. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wood, Kelleryn V can be contacted via phone (207) 828-1133.Contact Information
Primary practice address
800 Main St
South Portland ME 04106-6049
Phone: (207) 828-1133
Fax: (207) 828-8077
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 363L00000X | Maine |
Profile Details
| NPI number | 1598824591 |
|---|---|
| LBN Legal business name | Wood, Kelleryn V |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2006 |
| Last updated | Feb 4th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598824591 | NPPES |
| Maine | MEDICAID | 248410099 |
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