Provider Demographics
NPI:1942643770
Name:GUERRETTE, KRISTIN MARIE (DO)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:GUERRETTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 NORTH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2295
Mailing Address - Country:US
Mailing Address - Phone:207-764-3142
Mailing Address - Fax:207-760-8170
Practice Address - Street 1:23 NORTH ST STE 4
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2295
Practice Address - Country:US
Practice Address - Phone:207-764-3142
Practice Address - Fax:207-760-8170
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine