1922073220 NPI number — JENNIFER F WINSLOW NURSE PRACTITIONER

Table of content: JENNIFER F WINSLOW NURSE PRACTITIONER (NPI 1922073220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922073220 NPI number — JENNIFER F WINSLOW NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINSLOW
Provider First Name:
JENNIFER
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922073220
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
344 GILMANTON RD
Provider Second Line Business Mailing Address:
SUITE 420
Provider Business Mailing Address City Name:
BELMONT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03220-4212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-751-7052
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 420
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03060-2919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-577-3003
Provider Business Practice Location Address Fax Number:
603-577-3331
Provider Enumeration Date:
02/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  CNP 81889 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 041833-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010424957 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0799861 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010424957 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010424957 . This is a "STANDARD TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010424957 . This is a "EMPLOY STANDARDS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 041568 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 39200 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".




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