Individual
JACOB ELIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 CAMPUS AVE # 208, LEWISTON, ME 04240-6040
(207) 777-8974
Mailing address
111 BACK COVE DR, TURNER, ME 04282-3836
(207) 577-8765
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP231382
ME
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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