Individual
MRS. JESSIE SHERWOOD NAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
66 BRAMHALL ST, PORTLAND, ME 04102-3344
(207) 662-3157
(207) 662-4257
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R050975
ME
363LG0600X
Gerontology Nurse Practitioner
Primary
CNP131110
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R050975
RN LICENSE
ME
Enumeration date
02/01/2010
Last updated
05/11/2018
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