Provider Demographics
NPI:1043024243
Name:PAYNE, JENNA (CPM, LM)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BURNHAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:ME
Mailing Address - Zip Code:04941-3313
Mailing Address - Country:US
Mailing Address - Phone:508-309-8165
Mailing Address - Fax:
Practice Address - Street 1:12 BURNHAM HILL RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:ME
Practice Address - Zip Code:04941-3313
Practice Address - Country:US
Practice Address - Phone:508-309-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife