Provider Demographics
NPI:1477978161
Name:HENNESSY, JAYME ANN (WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:JAYME
Middle Name:ANN
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 EMORY STREET
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703
Mailing Address - Country:US
Mailing Address - Phone:781-595-4800
Mailing Address - Fax:781-595-3843
Practice Address - Street 1:150 EMORY STREET
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:781-595-4800
Practice Address - Fax:781-595-3843
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAHEN104380114363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health