Healthcare Provider Details

I. General information

NPI: 1023553344
Provider Name (Legal Business Name): JENNIFER L MCFADDEN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 PLEASANT ST
CONCORD NH
03301-7504
US

IV. Provider business mailing address

205 COBURN WOODS
NASHUA NH
03063-2861
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-6561
  • Fax:
Mailing address:
  • Phone: 603-318-1794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number039972-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: