Individual
JEANNIE M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
887 CONGRESS ST, SUITE 300, PORTLAND, ME 04102-3100
(207) 662-5522
(207) 662-5526
Mailing address
39 WALLACE AVE, SOUTH PORTLAND, ME 04106-6143
(207) 662-5522
(207) 662-5526
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R023443
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244920099
—
ME
05
—
30346655
—
NH
Enumeration date
03/26/2007
Last updated
10/22/2008
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