Individual provider · Type 1 NPI

Jacob Thomas William Record

Student in an Organized Health Care Education/Training Program · Portland, ME

NPI number 1457239386 Active

Practice location

716 Stevens Ave
Portland, ME 04103

Call (207) 221-4516 Map

Mailing address

716 Stevens Avenue
Portland, ME 04103

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XRN83209 (ME)

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.

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About NPI 1457239386

Jacob Thomas William Record's National Provider Identifier is 1457239386, issued on Aug 27, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, ME. The record was last updated on Aug 27, 2025.