Individual
MS. LORI B JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CCM
Contact information
Practice address
93 CAMPUS AVENUE, CASE MANAGEMENT DEPARTMENT, LEWISTON, ME 04240
(207) 777-8507
(207) 753-5488
Mailing address
CAMPUS AVENUE, PO BOX 291, CASE MANAGEMENT DEPARTMENT, LEWISTON, ME 04243-0291
(207) 777-8507
(207) 753-5488
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
R027612
ME
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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