Provider Demographics
NPI:1205532249
Name:BELANGER, JESSICA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:BELANGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ELLIOT WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3544
Mailing Address - Country:US
Mailing Address - Phone:603-669-9200
Mailing Address - Fax:603-669-9286
Practice Address - Street 1:4 ELLIOT WAY STE 200
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3544
Practice Address - Country:US
Practice Address - Phone:603-669-9200
Practice Address - Fax:603-669-9286
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH059435-23363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care