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General NPI Number Information
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NPI Number | 1184414856
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Entity Type | Individual
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Provider Name | JENNA HERRMANN PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 750 RESERVOIR AVE
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City | CRANSTON
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State | RI
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Zip | 02910-4423
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Country | US
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Telephone | 401-944-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 45 HAZELWOOD CT
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City | DALTON
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State | MA
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Zip | 01226-1904
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Country | US
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Telephone | 413-329-1147
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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