| Doctor Name: | JODY ANNIS |
| NPI Number: | 1578958161 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN35539 |
| Business Practice Address: | 891 W Main St Suite 200 Dover Foxcroft, ME - 044261059 |
| Business Phone Number: | 2075644157 |
| Business Fax Number: | |
| Mailing Address: | 891 W Main St, Suite 200 DOVER FOXCROFT |
| State: | ME |
| Postal Code: | 044261059 |
| Phone Number: | 2075644157 |
| Fax Number: | |
| NPI Enumeration Date: | 04/01/2015 |
| NPI Last Update Date: | 04/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | RN35539 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |