Provider Demographics
NPI:1245875426
Name:SWEETMAN, JENNIFER L (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:SWEETMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LOUISE
Other - Last Name:ELLIOTT - THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:70 EMORY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3181
Mailing Address - Country:US
Mailing Address - Phone:774-643-1790
Mailing Address - Fax:508-455-1025
Practice Address - Street 1:70 EMORY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3181
Practice Address - Country:US
Practice Address - Phone:774-643-1790
Practice Address - Fax:508-455-1025
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061885363A00000X
MAPA8781363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant