Provider Demographics
NPI:1578334389
Name:STEVENS, JENNIFER (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4940
Mailing Address - Country:US
Mailing Address - Phone:603-545-2622
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE PARK N STE 1A
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6951
Practice Address - Country:US
Practice Address - Phone:603-889-8648
Practice Address - Fax:603-882-9666
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH053146-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health