Provider Demographics
NPI:1821242611
Name:LEROYER, JENNIFER R (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:LEROYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5923
Mailing Address - Country:US
Mailing Address - Phone:978-683-4299
Mailing Address - Fax:978-688-9603
Practice Address - Street 1:555 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5923
Practice Address - Country:US
Practice Address - Phone:978-683-4299
Practice Address - Fax:978-688-9603
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2629363A00000X
NH0787363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant