Healthcare Provider Details

I. General information

NPI: 1427961358
Provider Name (Legal Business Name): JESSICA LYNN MILLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LYNN GALE PHARMD

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

IV. Provider business mailing address

5 MINNOW BROOK LN
FALMOUTH ME
04105-2708
US

V. Phone/Fax

Practice location:
  • Phone: 207-662-7976
  • Fax:
Mailing address:
  • Phone: 207-551-3420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License NumberPH233130
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License NumberPR27757
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: