Kristen M Ellensohn, APRN FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209004972 Issued in IL

Practice address

144 State St
Portland, ME 04101-3776

Phone

(207) 400-8500

Fax

(207) 400-8508

NPI assigned

Jun 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1689618563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-400-8500",
            "fax_number": "207-400-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-400-8500",
            "fax_number": "207-400-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENSOHN",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "APRN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209004972",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP141022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CNP141022",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209004972",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Allen Elgee, LCSW
• Faysal M Elgilani, MD
• Elikia Care Services LLC
• Katheryn Eliscu, RN
• Jenna Elkhoury, MD
• Jaime Eller, LCSW
• Sara A Ellingwood, M.S.
• Emily E Elliot, LCPC-C
• Amber R Elliott, LCSW
• Autumn Elliott

• Family Nurse Practitioner in Portland, ME
• Providers in Portland, 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 Feb 26, 2015; 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.