Healthcare Provider Details

I. General information

NPI: 1144853318
Provider Name (Legal Business Name): JENNIFER L MICHAUD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2020
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PIKES HL
NORWAY ME
04268-5340
US

IV. Provider business mailing address

8 PIKES HL
NORWAY ME
04268-5340
US

V. Phone/Fax

Practice location:
  • Phone: 207-744-6444
  • Fax: 207-743-6306
Mailing address:
  • Phone: 207-744-6444
  • Fax: 207-743-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP201041
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: