Provider Demographics
NPI:1235357831
Name:PARENT-NICHOLS, JENNIFER CATHERINE (MSPT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:PARENT-NICHOLS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 FEDERAL HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-3542
Mailing Address - Country:US
Mailing Address - Phone:603-672-9422
Mailing Address - Fax:
Practice Address - Street 1:72 FEDERAL HILL RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-3542
Practice Address - Country:US
Practice Address - Phone:603-672-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist