| Doctor Name: | KATHLEEN CHILDS |
| NPI Number: | 1619161346 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | R030792 |
| Business Practice Address: | 1073 W Main St Dover Foxcroft, ME - 044263742 |
| Business Phone Number: | 2073684213 |
| Business Fax Number: | 2073553033 |
| Mailing Address: | 118 Moosehead Trl, Suite 5 NEWPORT |
| State: | ME |
| Postal Code: | 049534055 |
| Phone Number: | 2073684213 |
| Fax Number: | 2073553033 |
| NPI Enumeration Date: | 09/06/2007 |
| NPI Last Update Date: | 09/06/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LC1500X |
| License Number: | R030792 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |