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NPI Profile for KIMBERLY R PETTENGILL in LEEDS, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1942674742 |
|
| Status | Active | |
| Credentials | FNP (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 11/18/2015 | |
| Last updated | 06/25/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KIMBERLY R PETTENGILL
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KIMBERLY R PETTENGILL, FNP