Provider Demographics
NPI:1699962969
Name:STONE, JERRI (NP)
Entity type:Individual
Prefix:
First Name:JERRI
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:76 HIGH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7649
Mailing Address - Country:US
Mailing Address - Phone:207-795-5544
Mailing Address - Fax:207-795-5645
Practice Address - Street 1:76 HIGH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7649
Practice Address - Country:US
Practice Address - Phone:207-795-5544
Practice Address - Fax:207-795-5645
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2011-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEAP081871363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000336601Medicare UPIN