Provider Demographics
NPI:1447507843
Name:BOOKER, JENNA BRIANNE (PA-C)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:BRIANNE
Last Name:BOOKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:BRIANNE
Other - Last Name:TURCOTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1138
Practice Address - Country:US
Practice Address - Phone:413-284-5308
Practice Address - Fax:413-284-5413
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5029363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT003027745Medicaid
CTD400078836 - C00814Medicare PIN