Provider Demographics
NPI:1184122830
Name:JENNIFER K STEBBING DO LLC
Entity type:Organization
Organization Name:JENNIFER K STEBBING DO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:KATSU
Authorized Official - Last Name:STEBBING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:603-436-0220
Mailing Address - Street 1:1 GREENLEAF WOODS DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5437
Mailing Address - Country:US
Mailing Address - Phone:603-436-0220
Mailing Address - Fax:603-373-8094
Practice Address - Street 1:1 GREENLEAF WOODS DR UNIT 102
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5437
Practice Address - Country:US
Practice Address - Phone:603-436-0220
Practice Address - Fax:603-373-8094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11642207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty