Provider Demographics
NPI:1285918110
Name:SONDERLAND, KIMBERLY (FNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SONDERLAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04643-3043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04643-3043
Practice Address - Country:US
Practice Address - Phone:207-483-4502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily