Basic Information
Provider Information
NPI: 1508351560
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLEN
FirstName: JAMIEE
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 468
Address2:  
City: SKOWHEGAN
State: ME
PostalCode: 049760468
CountryCode: US
TelephoneNumber: 2078588353
FaxNumber: 2074749261
Practice Location
Address1: 87 MERCER RD
Address2:  
City: NORRIDGEWOCK
State: ME
PostalCode: 04957
CountryCode: US
TelephoneNumber: 2076344366
FaxNumber: 2076344375
Other Information
ProviderEnumerationDate: 06/22/2018
LastUpdateDate: 12/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/10/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X47645MEN Nursing Service ProvidersRegistered Nurse 
363LF0000XCNP181118MEY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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