Individual provider · Type 1 NPI
Jacob Patrick Leidholm, CNP
Acute Care Nurse Practitioner · Portland, ME
NPI number
1922765197
Active
Practice location
22 Bramhall St
Portland, ME 04102-3134
Fax (207) 662-6254
Other practice locations
- 1 Medical Center Dr, Biddeford, ME 04005-9422 · (207) 283-7937
- 25 June St, Sanford, ME 04073-2621 · (207) 324-4310
- 55 Lake Ave N, Worcester, MA 01655-0002 · (508) 334-3452
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | RN2361554 (MA) |
| Acute Care Nurse Practitioner | 363LA2100X | RN2361554 (MA) |
| Acute Care Nurse Practitioner Primary | 363LA2100X | CNP231268 (ME) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1922765197
Jacob Patrick Leidholm, CNP's National Provider Identifier is 1922765197, issued on Nov 23, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Portland, ME. The record was last updated on Feb 24, 2026.