Provider Demographics
NPI:1083819064
Name:WHITTINGTON, JEANNE ANN (LIC AC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:ANN
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 BARNARD HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:DUNBARTON
Mailing Address - State:NH
Mailing Address - Zip Code:03046
Mailing Address - Country:US
Mailing Address - Phone:603-774-6555
Mailing Address - Fax:
Practice Address - Street 1:188 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-226-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHACP003171100000X
MA287171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist