Provider Demographics
NPI:1275844623
Name:MORIN, JACQUES JOSEPH (RN)
Entity Type:Individual
Prefix:MR
First Name:JACQUES
Middle Name:JOSEPH
Last Name:MORIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 411 P.O. BOX 964
Mailing Address - Street 2:JACQUES MORIN
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-0964
Mailing Address - Country:US
Mailing Address - Phone:49966-283-4020
Mailing Address - Fax:
Practice Address - Street 1:(4) DRAHTHAMMER, STR.
Practice Address - Street 2:
Practice Address - City:ANBERG
Practice Address - State:BAVARIA
Practice Address - Zip Code:92224
Practice Address - Country:DE
Practice Address - Phone:49966-283-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER034594163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MER034594OtherMAINE STATE BOARD OF NURSING
MER034594OtherMAINE STATE BOARD OF NURSING