Healthcare Provider Details

I. General information

NPI: 1720824063
Provider Name (Legal Business Name): JAIME LYNNE STANIELS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2024
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259A NORTH ST
HYANNIS MA
02601-3823
US

IV. Provider business mailing address

259A NORTH ST
HYANNIS MA
02601-3823
US

V. Phone/Fax

Practice location:
  • Phone: 508-862-0514
  • Fax: 508-862-0514
Mailing address:
  • Phone: 508-862-0514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2260234
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: