Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelley Qualters

Individual provider Adult Health Nurse Practitioner · NPI 1124761671

Kelley Qualters is a Nurse Practitioner in South Portland, Maine. Qualified in 2019, 7 years ago. Practices with Memorial Neurology Group, a 96-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2022

Practice location Address checks out

21 Grand St
South Portland, ME 04106-2217
Phone: (781) 893-6014
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 309069 (NY)

Record details

NPI number1124761671
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 13, 2022
Last updated in NPPESApril 13, 2022
Certification dateApril 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Memorial Neurology Group — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in South Portland