Individual
MISS JESSICA LYNNE HORNICKELL I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
3 BRAZIER LN, KENNEBUNK, ME 04043-7095
(207) 985-3030
Mailing address
25 POOL ST, BIDDEFORD, ME 04005-2877
(717) 639-1484
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10013724
PA
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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