Provider Demographics
NPI:1245467513
Name:JENNIFER DAIGLE, MSN, ARNP, LLC
Entity type:Organization
Organization Name:JENNIFER DAIGLE, MSN, ARNP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:207-347-7132
Mailing Address - Street 1:97 INDIA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4248
Mailing Address - Country:US
Mailing Address - Phone:207-347-7132
Mailing Address - Fax:207-347-3527
Practice Address - Street 1:97 INDIA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4248
Practice Address - Country:US
Practice Address - Phone:207-347-7132
Practice Address - Fax:207-347-3527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center