Healthcare Provider Details

I. General information

NPI: 1265123251
Provider Name (Legal Business Name): JENNIFER BIEN-AIME PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 HIGH ST STE 7
MEDFORD MA
02155-3808
US

IV. Provider business mailing address

3361 NW 47TH TER APT 333
LAUDERDALE LAKES FL
33319-6751
US

V. Phone/Fax

Practice location:
  • Phone: 919-767-5390
  • Fax:
Mailing address:
  • Phone: 954-549-8947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71018100A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11024940
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: