Provider Demographics
NPI:1770962094
Name:PARA, JENNIFER CATHERINE (CNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:PARA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CATHERINE
Other - Last Name:FIERRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 SCHOOL ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:NORTH BROOKFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01535-1962
Mailing Address - Country:US
Mailing Address - Phone:508-736-4012
Mailing Address - Fax:
Practice Address - Street 1:1400 COMPUTER DR STE 301
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1790
Practice Address - Country:US
Practice Address - Phone:617-420-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270717363LF0000X
CT7365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily