Provider Demographics
NPI:1275688368
Name:GILLARD, JENNIFER (CPNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GILLARD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:STROUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:POST ROAD PEDIATRICS, LLP
Mailing Address - Street 2:616 BOSTON POST RD
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3378
Mailing Address - Country:US
Mailing Address - Phone:978-443-6005
Mailing Address - Fax:978-443-8429
Practice Address - Street 1:POST ROAD PEDIATRICS, LLP
Practice Address - Street 2:616 BOSTON POST RD
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3378
Practice Address - Country:US
Practice Address - Phone:978-443-6005
Practice Address - Fax:978-443-8429
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN265934363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics