Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 97020007 | ME |
NPI | 1083931083 |
---|---|
Provider Name | Ms. Jill E. Breen |
First Address | Saint Albans, ME 04971-0001 |
Second Address | Saint Albans, ME 04971-7332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 29/04/2010 |