Provider Demographics
NPI:1457850968
Name:WECHSLER, JENEE R
Entity Type:Individual
Prefix:
First Name:JENEE
Middle Name:R
Last Name:WECHSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ENTERPRISE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7998
Mailing Address - Country:US
Mailing Address - Phone:207-621-8700
Mailing Address - Fax:
Practice Address - Street 1:15 ENTERPRISE DR STE 100
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7998
Practice Address - Country:US
Practice Address - Phone:207-621-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-10
Last Update Date:2018-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP181027363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care