Provider Demographics
NPI:1649460031
Name:MILLETT, JEFFREY MICHAEL (FNP)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:MILLETT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-945-0469
Mailing Address - Fax:
Practice Address - Street 1:43 WHITING HILL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1005
Practice Address - Country:US
Practice Address - Phone:207-945-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH065771-23363LF0000X
ME042387363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH000371303Medicare PIN