Staton, Jennifer A

Staton, Jennifer A is an individual health care provider with primary practice located at 26 City Hall Mall , Medford MA 02155-4754. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Staton, Jennifer A can be contacted via phone (781) 306-5100.

Contact Information

Primary practice address
26 City Hall Mall Medford MA 02155-4754
Phone: (781) 306-5100
Fax: (781) 306-5379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 217755 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 217755 Massachusetts

Profile Details

NPI number 1639131980
LBN Legal business name Staton, Jennifer A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated Jul 8th, 2007 - about 19 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 1639131980 NPPES
Massachusetts Other NP3042 BLUE CROSS
Massachusetts Other C198 BLUE CROSS
Massachusetts MEDICAID 0382680 BLUE CROSS

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