Provider Demographics
NPI:1982649729
Name:LESPERANCE, JENNIFER L (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:LESPERANCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WILLISTON AVE
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2219
Mailing Address - Country:US
Mailing Address - Phone:413-529-1847
Mailing Address - Fax:413-582-2566
Practice Address - Street 1:30 LOCUST STREET
Practice Address - Street 2:COOLEY DICKINSON HOSPITALIST PROGRAM
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-582-2563
Practice Address - Fax:413-582-2566
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233192363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP4836OtherBCBS OF MASS
MAUX5387Medicare PIN
MANP4836OtherBCBS OF MASS