Provider Demographics
NPI:1437035870
Name:BENASSI, JACKLYN J (FNP)
Entity type:Individual
Prefix:
First Name:JACKLYN
Middle Name:J
Last Name:BENASSI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ATWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3813
Mailing Address - Country:US
Mailing Address - Phone:617-691-7184
Mailing Address - Fax:
Practice Address - Street 1:24 ATWOOD ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3813
Practice Address - Country:US
Practice Address - Phone:617-691-7184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10003297363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily