NPI 1487100483

Annette Jordan

Practitioner Contractor South Portland, ME

Practice location

Address: 400 Southborough Dr, South Portland, ME 04106-3249
Phone: (207) 761-1100

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence MT2272 (ME)

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Registry record

NPI: 1487100483
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Aug 2016
Record last updated: 30 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.