Provider Demographics
NPI:1891533675
Name:BOILARD, KELSEY L (FNP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:L
Last Name:BOILARD
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 1:32 WELLINGTON CT UNIT 101
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-7334
Mailing Address - Country:US
Mailing Address - Phone:207-689-4553
Mailing Address - Fax:
Practice Address - Street 1:99 CAMPUS AVE STE 402
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6045
Practice Address - Country:US
Practice Address - Phone:207-777-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily