Individual
MR. JAMIE LEE THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
11 ROCK ROW STE 120, WESTBROOK, ME 04092-4877
(207) 303-3300
(207) 250-2139
Mailing address
PO BOX 911, BRATTLEBORO, VT 05302-0911
(207) 303-3200
(207) 250-2140
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP181272
ME
363LA2100X
Acute Care Nurse Practitioner
ARNP9376950
FL
Other
Enumeration date
09/18/2018
Last updated
04/21/2026
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