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Individual

JENNIFER DISSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
15 ENTERPRISE DR, AUGUSTA, ME 04330-7997
(207) 621-8880
Mailing address
26 FULLER RD, CUMBERLAND, ME 04021-3063
(207) 462-7360

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP201465
ME

Other

Enumeration date
01/26/2022
Last updated
01/26/2022
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