Individual
JAYDE FROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 CONCOURSE W, WATERVILLE, ME 04901-6007
(207) 873-1036
Mailing address
112 ELM ST APT A, NEWPORT, ME 04953-3195
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
CNP241140
ME
363LF0000X
Family Nurse Practitioner
Primary
CNP241140
ME
Other
Enumeration date
03/15/2024
Last updated
12/05/2024
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