Provider Demographics
NPI:1912094939
Name:MATNEY, JENNIFER E (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:MATNEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-580-7525
Mailing Address - Fax:603-580-7542
Practice Address - Street 1:5 ALUMNI DR FL 2
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2128
Practice Address - Country:US
Practice Address - Phone:603-580-7525
Practice Address - Fax:603-580-7542
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047963-23363L00000X
NH0479632312363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075897Medicaid
NHNP5467Medicare PIN
NH30344620Medicaid