MEDICARE: JOANNE THERRIEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	41152	ME

General Provider Information

NPI Number	:	1144694308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE THERRIEN

Provider Business Mailing Address
First Line	:	PO BOX 851
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-0851
Country	:	US
Telephone Number	:	207-491-1316
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 BARKER RD,
Second Line	:
City	:	NEW VINEYARD
State	:	ME
Zip	:	04956
Country	:	US
Telephone Number	:	207-491-1316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2015
Last Update Date	:	11/25/2015

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Directions to “ JOANNE THERRIEN ” Practice Location

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