Provider Demographics
NPI:1316085806
Name:LAPIERRE, KELLIE LAVIN (GNP- BC)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:LAVIN
Last Name:LAPIERRE
Suffix:
Gender:F
Credentials:GNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 W PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-4425
Mailing Address - Country:US
Mailing Address - Phone:508-277-2280
Mailing Address - Fax:
Practice Address - Street 1:15 STRAWBERRY AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5941
Practice Address - Country:US
Practice Address - Phone:207-777-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173339363LG0600X
MECNP211159363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology