Provider Demographics
NPI:1659162824
Name:BISSONNETTE, JENNIFER L (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BISSONNETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:MILLINOCKET
Mailing Address - State:ME
Mailing Address - Zip Code:04462-1948
Mailing Address - Country:US
Mailing Address - Phone:207-723-9534
Mailing Address - Fax:
Practice Address - Street 1:37 FOREST AVE
Practice Address - Street 2:
Practice Address - City:MILLINOCKET
Practice Address - State:ME
Practice Address - Zip Code:04462-1948
Practice Address - Country:US
Practice Address - Phone:207-723-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN88011163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health