Healthcare Provider Details

I. General information

NPI: 1780361188
Provider Name (Legal Business Name): JAIME NICOLE WILLIAMS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 ABBOTT ST STE 12
BREWER ME
04412-2291
US

IV. Provider business mailing address

2023 HEMLOCK DR
HERMON ME
04401-0274
US

V. Phone/Fax

Practice location:
  • Phone: 207-631-6141
  • Fax:
Mailing address:
  • Phone: 207-631-6141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberCNP231293
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: