Provider Demographics
NPI:1609685262
Name:JENNA JOLLY PMHNP-BC, FNP-BC PLLC
Entity type:Organization
Organization Name:JENNA JOLLY PMHNP-BC, FNP-BC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:413-221-6060
Mailing Address - Street 1:26 S PROSPECT ST STE 6
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2268
Mailing Address - Country:US
Mailing Address - Phone:413-547-4886
Mailing Address - Fax:413-296-9354
Practice Address - Street 1:26 S PROSPECT ST STE 6
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2268
Practice Address - Country:US
Practice Address - Phone:413-547-4886
Practice Address - Fax:413-296-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily