Provider Demographics
NPI:1962285619
Name:DOADES, JENNIFER N (BSN, RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:DOADES
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LEIGH
Other - Last Name:NEVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 COOPERS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ME
Mailing Address - Zip Code:04363-3827
Mailing Address - Country:US
Mailing Address - Phone:770-880-5289
Mailing Address - Fax:
Practice Address - Street 1:35 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8160
Practice Address - Country:US
Practice Address - Phone:207-626-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN79996163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse