Provider Demographics
NPI:1265908610
Name:POEL, JENNA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:MARIE
Last Name:POEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:JENNA
Other - Middle Name:MARIE
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:122 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-1643
Mailing Address - Country:US
Mailing Address - Phone:978-490-6187
Mailing Address - Fax:
Practice Address - Street 1:122 ESSEX ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-1643
Practice Address - Country:US
Practice Address - Phone:978-490-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2294367163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse