=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255393658
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER LIMONGIELLO PHD, FNP, PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2006
-----------------------------------------------------
Last Update Date | 04/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 NORTHERN BLVD STE 14
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03031-2325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-670-6593
-----------------------------------------------------
Fax | 800-967-5145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 NORTHERN BLVD STE 14
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03031-2325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-670-6593
-----------------------------------------------------
Fax | 800-967-5145
-----------------------------------------------------
=====================================================
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 | 052833-23-03
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 18663
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 186663
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------