IndividualActive
Kelley Qualters
NPI 1124761671 · Adult Health Nurse Practitioner · South Portland, ME
Provider details
- NPI number
- 1124761671
- Entity type
- Individual
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 309069 (NY)
Mailing address
21 Grand St
South Portland, ME 04106-2217
Registry dates
- Enumerated
- 2022-04-13
- Last updated
- 2022-04-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.