Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 064296-23 | NH |
NPI | 1003198516 |
---|---|
Provider Name | Mrs. Jennifer Eileen Jeanne Thompson |
First Address | Exeter, NH 03833-0655 |
Second Address | Epping, NH 03042-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2011 |
Last Update Date | 12/03/2014 |