Provider Demographics
NPI:1255393658
Name:LIMONGIELLO, JENNIFER (PHD, FNP, PMHNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LIMONGIELLO
Suffix:
Gender:
Credentials:PHD, FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 NORTHERN BLVD STE 14
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2325
Mailing Address - Country:US
Mailing Address - Phone:603-670-6593
Mailing Address - Fax:800-967-5145
Practice Address - Street 1:5 NORTHERN BLVD STE 14
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2325
Practice Address - Country:US
Practice Address - Phone:603-670-6593
Practice Address - Fax:800-967-5145
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH052833-23-03363L00000X
MA18663363LP0808X
MA186663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S80282Medicare UPIN