Healthcare Provider Details

I. General information

NPI: 1144181843
Provider Name (Legal Business Name): JENNA MAY DESCHAMPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 US ROUTE 1 STE C
SCARBOROUGH ME
04074-7174
US

IV. Provider business mailing address

71 US ROUTE 1 STE C
SCARBOROUGH ME
04074-7174
US

V. Phone/Fax

Practice location:
  • Phone: 207-883-5532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: