Healthcare Provider Details

I. General information

NPI: 1346629417
Provider Name (Legal Business Name): JAYMIE F ST. PETER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HARTFORD ST STE 4
HOULTON ME
04730-1862
US

IV. Provider business mailing address

PO BOX 40
CARIBOU ME
04736-0040
US

V. Phone/Fax

Practice location:
  • Phone: 207-532-4017
  • Fax: 207-532-4019
Mailing address:
  • Phone: 207-769-2025
  • Fax: 207-764-0629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP151057
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: