Provider Demographics
NPI:1255567988
Name:BRUNS MONTEMERLO, ERIKA KRISTIN (DC)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:KRISTIN
Last Name:BRUNS MONTEMERLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:BRUNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 STONEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04046-6040
Mailing Address - Country:US
Mailing Address - Phone:207-356-6888
Mailing Address - Fax:
Practice Address - Street 1:2 CHRISTENSEN LN
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7759
Practice Address - Country:US
Practice Address - Phone:207-356-8688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1903111NI0013X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0012630Medicare UPIN