Provider Demographics
NPI:1366137960
Name:LABREE, JACOB JAMES (PA-C, MPH, CPH)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:JAMES
Last Name:LABREE
Suffix:
Gender:M
Credentials:PA-C, MPH, CPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:269 CRANBERRY MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03901-2413
Mailing Address - Country:US
Mailing Address - Phone:207-343-0849
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9422
Practice Address - Country:US
Practice Address - Phone:207-294-5000
Practice Address - Fax:207-294-5227
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPA2589363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant