Provider Demographics
NPI:1437396611
Name:TROWBRIDGE, JENNIFER M (PNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:TROWBRIDGE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 LOWER WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2890
Mailing Address - Country:US
Mailing Address - Phone:413-536-2393
Mailing Address - Fax:413-536-1087
Practice Address - Street 1:150 LOWER WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2890
Practice Address - Country:US
Practice Address - Phone:413-536-2393
Practice Address - Fax:413-536-1087
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA275867363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMM07361121OtherMASSACHUSETTS SUBSTANCE CONTROL
MAMM1855901OtherDEA