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Jenna Woodall Bourgeois
Women's Health Nurse Practitioner in Deep River, Connecticut
NPI 1366176083

Jenna Woodall Bourgeois is a Women's Health Nurse Practitioner based in New Haven, CT and is specialized in Women's Health. Jenna Woodall Bourgeois practices in Deep River, CT. The NPI Number for Jenna Woodall Bourgeois is 1366176083 and holds a License No. 12.010268 (Connecticut).

The current practice location address for Jenna Woodall Bourgeois is 124 Main St # 2, Deep River, CT and can be reached out via phone at 860-526-1756.

Location: 124 Main St # 2, Deep River, CT, 06511-2673
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366176083
Provider Name
Jenna Woodall Bourgeois
Credential
Provider Entity Type
Individual
Gender
Female
Address
124 Main St # 2, Deep River, CT, 06511-2673
Phone Number
860-526-1756
Fax Number
Provider Enumeration Date
07/11/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
124 Main St # 2
City
Deep River
State
Connecticut
Zip
06417-1756
Phone Number
860-526-1756
Fax Number
person
Provider Business Mailing Address Details
Address
124 Main St # 2
City
Deep River
State
Connecticut
Zip
06417-1756
Phone Number
860-526-1756
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Women's Health
Taxonomy
363LW0102X
License No.
12.010268 (Connecticut)
Definition
Definition to come...
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