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

Individual provider Family Nurse Practitioner · NPI 1154547479

Kimberley R Fantasia, FNP is a Nurse Practitioner in Waterville, Maine. Qualified in 2007, 19 years ago. Practices with Gulfside Palliative Care, LLC, a 13-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
19
Licensed in
ME
In the registry since
2007
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

200 Kennedy Memorial Dr
Waterville, ME 04901-4526
Phone: (207) 681-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP081842 (ME)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R051730 (ME)

Record details

NPI number1154547479
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedApril 17, 2007
Last updated in NPPESSeptember 2, 2010

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Gulfside Palliative Care, Llc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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