Healthcare Provider Details

I. General information

NPI: 1891626362
Provider Name (Legal Business Name): JASPER BLAKE HOTCHKISS DNP, MBA, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

548 MAIN ST
WAYNE ME
04284-3157
US

IV. Provider business mailing address

548 MAIN ST
WAYNE ME
04284-3157
US

V. Phone/Fax

Practice location:
  • Phone: 207-944-4305
  • Fax:
Mailing address:
  • Phone: 207-944-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN49816
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: