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General NPI Number Information
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NPI Number | 1861678781
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Entity Type | Individual
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Provider Name | JENNIFER MARIE O'CONNOR PMHNP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 25 JUNE ST
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City | SANFORD
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State | ME
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Zip | 04073-2621
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Country | US
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Telephone | 207-490-7000
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Fax | 207-490-7002
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Provider Business Mailing Address
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Address Line | 25 JUNE ST
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City | SANFORD
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State | ME
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Zip | 04073-2621
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Country | US
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Telephone | 207-490-7000
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Fax | 207-490-7002
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP101026
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN55663
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License Number State | ME
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