JASPER DYLAN NUTT (NPI# 1285292441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285292441 |
| Entity Type | Individual |
| Full Name | JASPER DYLAN NUTT |
| Credential | MD |
| Practice Address |
895 Union St Ste 12 Bangor ME 04401-3054 |
| Mailing Address |
43 Whiting Hill Rd Ste 300 Brewer ME 04412-1006 |
| Practice Telephone | 2079737979 |
| Practice Fax Number | 2079479579 |
| Mailing Telephone | 2079735035 |
| Mailing Fax Number | 2079735042 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
895 UNION ST STE 12 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-3054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225127905 | Lewis E Mehl-madrona | Family Medicine | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2006-10-12 |
| 1063030534 | Cassandra Terri Lynn Butt | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-10 |
| 1023636503 | Dane Wanniarachige | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-10 |
| 1477171585 | Katie Helen Lockhart | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-07 |
| 1013534312 | Callaghan Joseph Gillis | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-02 |
| 1922625532 | Karsen Ross Seto | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-06-30 |
| 1356968978 | Ashley Taylor Rivers | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-06-30 |
| 1750904827 | Jonathan Herbert Rieder | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-05-25 |
| 1669095717 | Cameron Michael Burke | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-05-24 |
| 1154944312 | Mollie Ruth Myers | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639634785 | Gracey Mae Eden | Student in an Organized Health Care Education/Training Program | 712 Laurel Hill Rd, Bangor, PA 18013-5564 | 2019-02-04 |
| 1376020412 | Stephen Mark Lovell Jr. | Student in an Organized Health Care Education/Training Program | 35 Silver Rd, Bangor, ME 04401-5826 | 2018-07-22 |
| 1255843603 | Meghan Elizabeth Frank | Student in an Organized Health Care Education/Training Program | 582 Grandview Ave, Bangor, ME 04401-3232 | 2017-10-25 |
| 1417474362 | Seok Yoon | Student in an Organized Health Care Education/Training Program | 113 1/2 Pine St, Bangor, ME 04401-5213 | 2017-08-23 |
| 1295258499 | Paul Eyong Besong | Student in an Organized Health Care Education/Training Program | 750 Unoin Street, Bangor, ME 04401 | 2017-07-19 |
| 1477817682 | Patrice Aime Nya | Student in an Organized Health Care Education/Training Program | 201 Husson Ave Apt U12, Bangor, ME 04401-3168 | 2012-07-02 |
| 1144484296 | Supriya Gupta | Student in an Organized Health Care Education/Training Program | 302 Husson Avenue, Suite 1, Bangor, ME 04401 | 2008-07-17 |
| 1063030534 | Cassandra Terri Lynn Butt | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-10 |
| 1023636503 | Dane Wanniarachige | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-10 |
| 1477171585 | Katie Helen Lockhart | Student in an Organized Health Care Education/Training Program | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2020-07-07 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.