Provider Demographics
NPI:1417358805
Name:WREN-GREEN, JAMIE L (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:WREN-GREEN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 FILES HILL RD
Mailing Address - Street 2:
Mailing Address - City:THORNDIKE
Mailing Address - State:ME
Mailing Address - Zip Code:04986-3121
Mailing Address - Country:US
Mailing Address - Phone:207-322-3207
Mailing Address - Fax:
Practice Address - Street 1:474 FILES HILL RD
Practice Address - Street 2:
Practice Address - City:THORNDIKE
Practice Address - State:ME
Practice Address - Zip Code:04986-3121
Practice Address - Country:US
Practice Address - Phone:207-322-3207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN55022163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse