Provider Demographics
NPI:1316057607
Name:KUNAS, STACIE L (NP)
Entity type:Individual
Prefix:
First Name:STACIE
Middle Name:L
Last Name:KUNAS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:12 HIGH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7676
Mailing Address - Country:US
Mailing Address - Phone:207-795-2100
Mailing Address - Fax:207-795-2119
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7676
Practice Address - Country:US
Practice Address - Phone:207-795-2100
Practice Address - Fax:207-795-2119
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-10-31
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Provider Licenses
StateLicense IDTaxonomies
MECNP81334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENP5208Medicare PIN