Jenna W Bourgeois
Nurse Practitioner, Women's Health in Deep River, Connecticut
1366176083- Practice location
- 124 Main St # 2, Deep River, CT 06417-1756
- Phone
- 860-526-1756
- Fax
- —
- Last updated
- July 11, 2022
Jenna Woodall Bourgeois is a Nurse Practitioner, Women's Health based in Deep River, CT. Jenna Woodall Bourgeois practices in Deep River, CT. The NPI Number for Jenna Woodall Bourgeois is 1366176083 and holds a License No. 12.010268 (CT). The current practice location address for Jenna Woodall Bourgeois is 124 Main St # 2, Deep River, CT 06417-1756 and can be reached out via phone at 860-526-1756.
Provider Profile Details
- NPI Number
- 1366176083
- Provider Name
- Jenna Woodall Bourgeois
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 124 Main St # 2, Deep River, CT 06417-1756
- Phone Number
- 860-526-1756
- Primary Taxonomy
- Nurse Practitioner, Women's Health · 363LW0102X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 11, 2022
- Last Update Date
- July 11, 2022
- Certification Date
- May 24, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 124 Main St # 2
Deep River, CT 06417-1756 - City
- Deep River
- State
- Connecticut
- Zip
- 06417-1756
- Phone Number
- 860-526-1756
Provider Business Mailing Address Details
- Address
- 156 Willow St Apt 1
New Haven, CT 06511-2673 - City
- New Haven
- State
- CT
- Zip
- 06511-2673
- Phone Number
- 203-249-1361
License Information
- License Number
- 12.010268
- License State
- CT
- Taxonomy
- Nurse Practitioner, Women's Health · 363LW0102X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jenna W Bourgeois?
The NPI number of Jenna W Bourgeois is 1366176083. It was assigned on July 11, 2022 and is currently active in the NPPES registry.
What is the specialty of Jenna W Bourgeois?
Jenna W Bourgeois is registered under the primary taxonomy Nurse Practitioner, Women's Health (code 363LW0102X), licensed in CT under license number 12.010268.
Where does Jenna W Bourgeois practice?
The practice location is 124 Main St # 2, Deep River, CT 06417-1756. The office can be reached at 860-526-1756 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1366176083 directly on the NPPES registry website.