Jane Beaudoin, N.P.
Individual provider Active NPI Nurse Practitioner · Bangor, ME
NPI 1144255142 · NPPES record last updated Mar 27, 2008
Key facts
- NPI
- 1144255142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 20833 (ME)
- Practice address
- 489 State St
Bangor, ME 04401-6616 - Phone
- (207) 973-7000
- Fax
- (207) 973-5042
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20833 | ME | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norumbega Medical Specialists, LTD | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 20833 | ME | Yes |
Addresses
Primary practice location
489 State St
Bangor, ME 04401-6616
Mailing address
43 Whiting Hill Rd
Suite 300
Brewer, ME 04412-1005
Phone (207) 973-5035
Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.