Provider Demographics
NPI:1962461335
Name:EILE, JENNIFER (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:EILE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BRAUNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP
Mailing Address - Street 1:300 LONGWOOD AVENUE CHILDREN'S HOSPITAL BOSTON
Mailing Address - Street 2:FEGAN 706 - DIVISION OF HEMATOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-355-2457
Mailing Address - Fax:671-730-0641
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:FEGAN 706 - DIVISION OF HEMATOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-2457
Practice Address - Fax:671-730-0641
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190614363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics