Provider Demographics
NPI:1992441661
Name:RUNNELLS, KAILEEN APRIL (PMHNP)
Entity type:Individual
Prefix:
First Name:KAILEEN
Middle Name:APRIL
Last Name:RUNNELLS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12448
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4015
Mailing Address - Country:US
Mailing Address - Phone:207-538-3700
Mailing Address - Fax:
Practice Address - Street 1:188 SUMMER ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1129
Practice Address - Country:US
Practice Address - Phone:207-538-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP221215363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health