Individual
JACQUELINE P FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-0111
(207) 795-7133
Mailing address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-0111
(207) 795-7133
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP081922
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433709099
—
ME
Enumeration date
02/03/2009
Last updated
04/09/2014
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