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General NPI Number Information
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NPI Number | 1821760372
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Entity Type | Individual
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Provider Name | JENNIFER MARJORIE CORMIER FNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 12/02/2023
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Provider Practice Location Address
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Address Line | 874 PURCHASE ST
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City | NEW BEDFORD
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State | MA
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Zip | 02740-6232
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Country | US
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Telephone | 508-992-6553
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Fax | 508-997-2498
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Provider Business Mailing Address
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Address Line | 161 SPRUCE ST
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City | MIDDLEBORO
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State | MA
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Zip | 02346-3113
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Country | US
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Telephone | 508-353-6523
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 234911
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN234911
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License Number State | MA
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