Provider Demographics
NPI:1093316093
Name:STILLMAN, JENNY LYNN (APRN-C)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LYNN
Last Name:STILLMAN
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:LYNN
Other - Last Name:POLLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-C
Mailing Address - Street 1:139 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:TILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03276-5415
Mailing Address - Country:US
Mailing Address - Phone:603-527-4400
Mailing Address - Fax:
Practice Address - Street 1:139 WINTER ST
Practice Address - Street 2:
Practice Address - City:TILTON
Practice Address - State:NH
Practice Address - Zip Code:03276-5415
Practice Address - Country:US
Practice Address - Phone:603-527-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH063382-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily