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General NPI Number Information
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NPI Number | 1548372923
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Entity Type | Individual
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Provider Name | JODIE L TOMPKINS NP
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 1321 WASHINGTON AVENUE SUITE 310
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City | PORTLAND
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State | ME
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Zip | 04103-3675
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Country | US
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Telephone | 207-780-6565
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Fax | 207-878-6565
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Provider Business Mailing Address
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Address Line | 22 W COLE RD STE 101
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City | BIDDEFORD
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State | ME
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Zip | 04005-9431
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Country | US
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Telephone | 207-780-6565
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Fax | 207-878-6565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R049271
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License Number State | ME
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