Landry, Jennifer A.
Landry, Jennifer A. is an individual health care provider with primary practice located at 84 Marginal Way Suite 700, Portland ME 04101. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Landry, Jennifer A. can be contacted via phone (207) 774-5816.Contact Information
Primary practice address
84 Marginal Way Suite 700
Portland ME 04101
Phone: (207) 774-5816
Fax: (207) 523-8597
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA177 | Maine |
Profile Details
| NPI number | 1790740835 |
|---|---|
| LBN Legal business name | Landry, Jennifer A. |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Dec 9th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790740835 | NPPES |
| Maine | MEDICAID | 284210099 |
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