Provider Demographics
NPI:1477383446
Name:SMITH, JENNA ELIZABETH (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04350-3346
Mailing Address - Country:US
Mailing Address - Phone:540-742-0047
Mailing Address - Fax:
Practice Address - Street 1:295C KENNEDY MEMORIAL DR STE 1
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4564
Practice Address - Country:US
Practice Address - Phone:207-873-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241337363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily