=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114847233
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER L GRELLE APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2026
-----------------------------------------------------
Last Update Date | 07/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 133 FALMOUTH RD STE 2B
-----------------------------------------------------
City | MASHPEE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02649-2611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-301-1971
-----------------------------------------------------
Fax | 508-638-6466
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 HERITAGE DR
-----------------------------------------------------
City | NORTH EASTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02356-2214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-809-9614
-----------------------------------------------------
Fax | 508-638-6466
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 08-7586-21
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | RN256818
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------