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NPI Code Detail

MEDICARE: THERESA ANNE FENNELL

MEDICARE:   THERESA ANNE FENNELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNH

General Provider Information

NPI Number : 1487512240
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA ANNE FENNELL
Provider Business Mailing Address
First Line : 46 MAPLE ST APT 3
Second Line :
City : LITTLETON
State : NH
Zip : 03561-4734
Country : US
Telephone Number : 937-768-2069
Fax Number :
Provider Business Practice Location Address
First Line : 46 MAPLE ST APT 3
Second Line :
City : LITTLETON
State : NH
Zip : 03561-4734
Country : US
Telephone Number : 937-768-2069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/16/2026

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Directions to “ THERESA ANNE FENNELL ” Practice Location

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