Kristin Rackliffe, RN
Individual provider Active NPI Registered Nurse · Wilton, ME
NPI 1780944728 · NPPES record last updated May 24, 2012
Key facts
- NPI
- 1780944728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN48745 (ME)
- Practice address
- 284 Main St
Suite 190
Wilton, ME 04294-3044 - Phone
- (207) 333-7889
- NPI assigned
- May 24, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN48745 | ME | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN48745 | ME | Yes |
Addresses
Primary practice location
284 Main St
Suite 190
Wilton, ME 04294-3044
Mailing address
PO Box 565
Strong, ME 04983-0565
Phone (207) 333-7889
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016000001 | Medicaid | ME |
Other providers in Wilton, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.