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Individual

JENNIFER L HARVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
992 UNION ST, BANGOR, ME 04401-3057
(207) 992-2601
(207) 404-8351
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA702
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
305890099
ME
Enumeration date
06/21/2005
Last updated
07/19/2021
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