Provider Demographics
NPI:1316929672
Name:BRESETT, JENNIFER MARIE (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:BRESETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MADAWASKA
Mailing Address - State:ME
Mailing Address - Zip Code:04756-1014
Mailing Address - Country:US
Mailing Address - Phone:207-728-7300
Mailing Address - Fax:207-728-3838
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MADAWASKA
Practice Address - State:ME
Practice Address - Zip Code:04756-1014
Practice Address - Country:US
Practice Address - Phone:207-728-7300
Practice Address - Fax:207-728-3838
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER041586363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner