Provider Demographics
NPI:1952652448
Name:DUBORD, JACQUELINE MARIE (CPM, NHCM)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIE
Last Name:DUBORD
Suffix:
Gender:F
Credentials:CPM, NHCM
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:MARIE
Other - Last Name:LAMBERTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPM, NHCM
Mailing Address - Street 1:28 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-1110
Mailing Address - Country:US
Mailing Address - Phone:207-647-5968
Mailing Address - Fax:207-647-5919
Practice Address - Street 1:28 S HIGH ST
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-1110
Practice Address - Country:US
Practice Address - Phone:207-647-5968
Practice Address - Fax:207-647-5919
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM338176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3096289Medicaid