Healthcare Provider Details

I. General information

NPI: 1437005063
Provider Name (Legal Business Name): JAIMESON BJORKLUND PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 1ST AVE
BOSTON MA
02129-4557
US

IV. Provider business mailing address

22 BRAMHALL ST
PORTLAND ME
04102-3175
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2947
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10015401
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN91693
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: