Healthcare Provider Details

I. General information

NPI: 1497344279
Provider Name (Legal Business Name): JARED MICHAEL SEAVEY ACNPC-AG, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JARED MICHAEL SANDERS ACNPC-AG, FNP-C

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 REYNOLDS RD
BROOKS ME
04921-3637
US

IV. Provider business mailing address

55 REYNOLDS RD
BROOKS ME
04921-3637
US

V. Phone/Fax

Practice location:
  • Phone: 207-722-3488
  • Fax: 207-560-3977
Mailing address:
  • Phone: 207-722-3488
  • Fax: 207-560-3977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2021005462
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP221671
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP221671
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP221671
License Number StateME
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP221671
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: