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General NPI Number Information
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NPI Number | 1912488149
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Entity Type | Individual
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Provider Name | JARED J MORIN APRN
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Gender | Male
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Dates
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Enumeration Date | 08/26/2018
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Last Update Date | 08/26/2018
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Provider Practice Location Address
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Address Line | 12 HIGH ST
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City | LEWISTON
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State | ME
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Zip | 04240-7676
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Country | US
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Telephone | 207-795-5730
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Fax |
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Provider Business Mailing Address
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Address Line | 48 EIGHTH ST
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City | AUBURN
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State | ME
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Zip | 04210-5626
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Country | US
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Telephone | 207-240-6858
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | CNP181212
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License Number State | ME
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