Provider Demographics
NPI:1083154710
Name:BYRNES, JENNIFER LYNN (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BYRNES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:BENTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:538 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1227
Mailing Address - Country:US
Mailing Address - Phone:508-336-9200
Mailing Address - Fax:508-342-1917
Practice Address - Street 1:538 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-1227
Practice Address - Country:US
Practice Address - Phone:508-336-9200
Practice Address - Fax:508-342-1917
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01751363LF0000X
MARN278755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily