Provider Demographics
NPI:1558720706
Name:DODD, JEANNIE MARIE (CNP, NNP-BC)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:MARIE
Last Name:DODD
Suffix:
Gender:F
Credentials:CNP, NNP-BC
Other - Prefix:
Other - First Name:JEANNIE
Other - Middle Name:MARIE
Other - Last Name:CONRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1629
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:759 CHESTNUT ST
Practice Address - Street 2:W2810
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199
Practice Address - Country:US
Practice Address - Phone:413-794-5370
Practice Address - Fax:413-794-5100
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN227464363LN0000X
SC25697363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal