Provider Demographics
NPI:1275977050
Name:O'CONNOR, JENNIANNE (DVM)
Entity Type:Individual
Prefix:DR
First Name:JENNIANNE
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HOLLY TREE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-3119
Mailing Address - Country:US
Mailing Address - Phone:617-686-2683
Mailing Address - Fax:
Practice Address - Street 1:34 HOLLY TREE LN
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-3119
Practice Address - Country:US
Practice Address - Phone:617-686-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000007269174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000007269OtherVETERINARY LICENSE NUMBER