Provider Demographics
NPI:1699753749
Name:DRAWBRIDGE, JENNIFER (CNM, RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DRAWBRIDGE
Suffix:
Gender:F
Credentials:CNM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MASALIN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04849-5542
Mailing Address - Country:US
Mailing Address - Phone:207-763-4665
Mailing Address - Fax:
Practice Address - Street 1:22 WHITE ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2978
Practice Address - Country:US
Practice Address - Phone:207-594-3114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-08
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME044302367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife