Individual
MRS. JESSICA R DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12 SCHUMAN AVE, AUGUSTA, ME 04330-0433
(207) 307-0958
Mailing address
71 MATTSON HTS, GARDINER, ME 04345-2810
(207) 554-0741
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP221637
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNP221637
MAINE STATE BOARD OF NURSING
ME
Enumeration date
11/28/2022
Last updated
01/04/2023
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