Healthcare Provider Details

I. General information

NPI: 1881258283
Provider Name (Legal Business Name): CASSIDY JAYNE FENTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSIDY JAYNE AUGER PA-C

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 US ROUTE 1 STE 3S
FALMOUTH ME
04105-1352
US

IV. Provider business mailing address

367 US ROUTE 1 STE 3S
FALMOUTH ME
04105-1352
US

V. Phone/Fax

Practice location:
  • Phone: 207-518-8869
  • Fax:
Mailing address:
  • Phone: 603-410-6700
  • Fax: 603-319-8308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2091
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: