Provider Demographics
NPI:1699135384
Name:KILROY, EMILY FRASER (FNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FRASER
Last Name:KILROY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:FRASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 BRICKYARD LN STE B
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1687
Mailing Address - Country:US
Mailing Address - Phone:207-606-2032
Mailing Address - Fax:207-606-2039
Practice Address - Street 1:1 BRICKYARD LN STE B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1687
Practice Address - Country:US
Practice Address - Phone:207-606-2032
Practice Address - Fax:207-606-2039
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP171117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3103769Medicaid
NH3103769Medicaid
NHT400298841Medicare PIN