Fairlie, Jenna

Fairlie, Jenna is an individual health care provider with primary practice located at 181 Park Ave Ste 5 , W Springfield MA 01089-3365. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Fairlie, Jenna can be contacted via phone (413) 796-7499.

Contact Information

Primary practice address
181 Park Ave Ste 5 W Springfield MA 01089-3365
Phone: (413) 796-7499
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2269619 Massachusetts

Profile Details

NPI number 1457830515
LBN Legal business name Fairlie, Jenna
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2018
Last updated Aug 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457830515 NPPES
Massachusetts Other 2269619 LICENSE

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