Provider Demographics
NPI:1841607041
Name:LACASSE, JENNIFER ANN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:LACASSE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02668-1152
Mailing Address - Country:US
Mailing Address - Phone:508-744-7105
Mailing Address - Fax:866-711-4542
Practice Address - Street 1:1049 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02668-1152
Practice Address - Country:US
Practice Address - Phone:508-744-7105
Practice Address - Fax:866-711-4542
Is Sole Proprietor?:No
Enumeration Date:2014-07-20
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN229501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400182192Medicare PIN