Healthcare Provider Details

I. General information

NPI: 1023316353
Provider Name (Legal Business Name): ROLAND JAMES PAULETTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 HILLSIDE DR
ORRINGTON ME
04474-3809
US

IV. Provider business mailing address

37 HILLSIDE DR
ORRINGTON ME
04474-3809
US

V. Phone/Fax

Practice location:
  • Phone: 207-949-7663
  • Fax:
Mailing address:
  • Phone: 207-949-7663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: