Provider Demographics
NPI:1154638138
Name:CANESI, JENNIFER C (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:CANESI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9 HAWTHORNE PL APT 9K
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2325
Mailing Address - Country:US
Mailing Address - Phone:508-566-5797
Mailing Address - Fax:617-557-4140
Practice Address - Street 1:9 HAWTHORNE PL APT 9K
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2325
Practice Address - Country:US
Practice Address - Phone:508-566-5797
Practice Address - Fax:617-557-4140
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN280283363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner