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1457107120 NPI number — JENIFER ERIN FERNSTROM FNP

NPI Number: 1457107120
Health Care Provider/Practitioner: JENIFER ERIN FERNSTROM FNP

Information about “1457107120” NPI (JENIFER ERIN FERNSTROM FNP) exists in 1457107120 in HTML format HTML  |  1457107120 in plain Text format TXT  |  1457107120 in PDF (Portable Document Format) PDF  |  1457107120 in an XML format XML  formats.

NPI Number : 1457107120 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457107120",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FERNSTROM",
    "FirstName": "JENIFER",
    "MiddleName": "ERIN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "COUTU",
    "OtherFirstName": "JENIFER",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "594 GREAT RD STE 102A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH SMITHFIELD",
    "MailingAddressStateName": "RI",
    "MailingAddressPostalCode": "02896-6810",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "401-768-3400",
    "MailingAddressFaxNumber": "401-768-3402",
    "FirstLinePracticeLocationAddress": "594 GREAT RD STE 102A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORTH SMITHFIELD",
    "PracticeLocationAddressStateName": "RI",
    "PracticeLocationAddressPostalCode": "02896-6810",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "401-768-3400",
    "PracticeLocationAddressFaxNumber": "401-768-3402",
    "EnumerationDate": "04/24/2024",
    "LastUpdateDate": "02/05/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "APRN04029",
        "LicenseNumberStateCode": "RI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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