Kimberly Ann Boutwell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP161103 Issued in ME

Practice address

331 Maine St Ste 6
Brunswick, ME 04011-3359

Phone

(802) 558-0134

NPI assigned

Aug 16, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1285189654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DEERFIELD DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113543",
            "telephone_number": "802-558-0134",
            "fax_number": "207-753-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 MAINE ST STE 6",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113359",
            "telephone_number": "802-558-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTWELL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP161103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence David Bossong, DDS
• Lilia Bottino, LMSW-CC
• Gerard P. Bouchard, RPH
• Christiana Boucher
• Laura Boutin, CCC-SLP
• Megan A Bowdich, LCPC
• Bproactive Health PLLC
• Eva Anne Bradford, D.O.
• Buffie Breed, OT/L
• Avery Brennan

• Family Nurse Practitioner in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.