Provider Demographics
NPI:1952536807
Name:BOURGEOIS, JAMIE J (CNM)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:J
Last Name:BOURGEOIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:J
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:88 MCGREGOR ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3750
Mailing Address - Country:US
Mailing Address - Phone:603-629-1799
Mailing Address - Fax:
Practice Address - Street 1:88 MCGREGOR ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3750
Practice Address - Country:US
Practice Address - Phone:603-629-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH054241-23176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife