Kristen Mickkelsen Pmhnp BC LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP121069 Issued in ME

Legal business name

KRISTEN MICKKELSEN PMHNP BC LLC

Practice address

1321 Washington Ave
Suite 304
Portland, ME 04103-3636

Phone

(207) 536-3088

Fax

(207) 536-3092

NPI assigned

Dec 19, 2016

Organization subpart

No

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

Authorized official

Name

Kristin A Mikkelsen, PMHNP

Title

Owner

Phone

(207) 536-3088

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1528502002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SUNSET RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052490",
            "telephone_number": "207-536-3088",
            "fax_number": "207-536-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 WASHINGTON AVE",
            "address_2": "SUITE 304",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033636",
            "telephone_number": "207-536-3088",
            "fax_number": "207-536-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTEN MICKKELSEN PMHNP BC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "MIKKELSEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-536-3088",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP121069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter H Krauth, M.D.
• Vesna Kravljaca
• Noah Daniel Krell, LCSW
• Gary Kribel, PHARMD
• Cassandre Krier, MD
• Danielle Adler Kroot, PT, DPT
• Padmaja Krothapalli
• Maja Krsmanovic, OD
• Wayne A Kruithoff, M.D.
• Erin E Krumpe

• Psychiatric/Mental Health Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.