Healthcare Provider Details

I. General information

NPI: 1154430023
Provider Name (Legal Business Name): JANE G. ADAMS APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 SANFORD RD SUITE 2A
WELLS ME
04090-5533
US

IV. Provider business mailing address

15 HOSPITAL DR MEDICAL STAFF OFFICE
YORK ME
03909-1011
US

V. Phone/Fax

Practice location:
  • Phone: 207-641-8044
  • Fax: 207-854-1516
Mailing address:
  • Phone: 207-351-2478
  • Fax: 207-351-2153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number048539
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: