JACLYN LUCKHARDT


Address: 37 College Ave, Gorham, ME 04038-1032
Phone: 6038458427

JACLYN LUCKHARDT (NPI# 1184274631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184274631
Entity Type Individual
Full Name JACLYN LUCKHARDT
Practice Address 37 College Ave
Gorham
ME 04038-1032
Practice Telephone 6038458427
Enumeration Date 2019-09-17
Last Update Date 2019-09-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Office Location

Street Address 37 COLLEGE AVE
City GORHAM
State ME
Zip Code 04038-1032

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720026818 Mary M Scannell Nurse Practitioner 37 College Ave, 110 Upton Hall, Gorham, ME 04038-1032 2006-06-02
1801446356 Allison Elizabeth Little Student in an Organized Health Care Education/Training Program 37 College Ave, Gorham, ME 04038-1099 2019-09-17
1871077271 Alexandra Srolovitz Specialist/Technologist 37 College Ave, Gorham, ME 04038-1032 2018-09-20
1770067647 Joseph Rand Davenport II Specialist/Technologist 37 College Ave, Gorham, ME 04038-1032 2018-09-18
1487138434 Logan L Gailitis Specialist/Technologist 37 College Ave, Gorham, ME 04038-1032 2018-09-15
1205336161 Kelleigh O'neill Specialist/Technologist 37 College Ave, Gorham, ME 04038-1032 2018-02-17
1992166847 Shelby Watts Specialist/Technologist 37 College Ave, Gorham, ME 04038 2016-03-18
1518335462 Samar Jamali Nurse Practitioner 37 College Ave, University Health and Counseling, Gorham, ME 04038-1032 2015-09-09
1821498957 Benjamin Towne Specialist/Technologist 37 College Ave, Costello Sports Complex, Gorham, ME 04038-1032 2014-08-26
1780020941 University of Maine System Clinic/Center 37 College Ave, 125 Upton Hall, Gorham, ME 04038-1032 2013-05-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134749039 Lindsey Anne Thomsen Physician Assistant 15 Caitlin Drive, Gorham, ME 04038 2020-04-21
1124537600 Helping Hearts Home Care Home Health 46 Farrington Rd, Gorham, ME 04038 2017-09-27
1689109019 Deborah Ann Cooper In Home Supportive Care 46 Farrington Road, Gorham, ME 04038 2017-04-24
1184056400 Katherine Pritchard Speech-Language Pathologist 1002 Wagner Farm Road, Gorham, ME 04038 2013-08-09
1043565013 Jennifer Brooke Turcotte Social Worker 697b Gray Rd, Gorham, ME 04038 2012-07-17
1326356296 Gail Trefethern-kelley Occupational Therapist 75 School Street, Suite 2, Gorham, ME 04038 2010-09-14
1396963245 Jaime Marie Tardif Social Worker 72 Justice Way, Gorham, ME 04038 2007-04-23
1033234224 Marie A Pedersen Social Worker 39 Finn Parker Road, Gorham, ME 04038 2007-03-20
1205971330 Victor Liberi Specialist/Technologist 33 College Ave., University of So. Maine, Gorham, ME 04038 2007-02-20
1467595322 Susanne Martornao Occupational Therapist 14 Murray Drive, Gorham, ME 04038 2007-02-14
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Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

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.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881224848 Narissa Mae Libby Student in an Organized Health Care Education/Training Program 9 Queen St, Gorham, ME 04038-2628 2020-01-17
1821531229 Jessica Stewart Student in an Organized Health Care Education/Training Program 80 Lancaster Rd, Gorham, NH 03581-1411 2016-12-02
1801446356 Allison Elizabeth Little Student in an Organized Health Care Education/Training Program 37 College Ave, Gorham, ME 04038-1099 2019-09-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1720602964 Ci Yen Joanna Man Student in an Organized Health Care Education/Training Program 190 Park Ave., Portland, ME 04102 2020-06-03
1609498948 Callan Donovan Student in an Organized Health Care Education/Training Program 8 Hedgerow Dr, Falmouth, ME 04105-1407 2020-05-09
1588285977 Robert Rousseau Student in an Organized Health Care Education/Training Program 745 W Auburn Rd, Auburn, ME 04210-8506 2020-04-27
1639708050 Jeffrey Littlefield Student in an Organized Health Care Education/Training Program 55a Blueberry Ln, Gray, ME 04039-9734 2020-04-07
1174152920 John Weare Knight Student in an Organized Health Care Education/Training Program 1901 Us Route 1, Cape Neddick, ME 03902-7530 2020-04-03
1023647898 Jillian Mei-ling Liu Student in an Organized Health Care Education/Training Program 22 Bramhall St # 5323a, Portland, ME 04102-3134 2020-04-03
1124656863 Zachary Bernard Tillett Student in an Organized Health Care Education/Training Program Maine Medical Center 22 Bramhall St., Portland, ME 04102 2020-03-30
1790313781 Brianna Marie Philbrick Student in an Organized Health Care Education/Training Program 22 Bramhall St # 2b, Portland, ME 04102-3175 2020-03-27
1215564323 Joshua Allen Swenson Student in an Organized Health Care Education/Training Program 33 Bramhall St, Portland, ME 04102 2020-03-26
1639706997 Julia Rosner Student in an Organized Health Care Education/Training Program 22 Bramhall St # P5a5323, Portland, ME 04102-3175 2020-03-26
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Competitor

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City GORHAM
Zip Code 04038

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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