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Individual
JODY A DUGRENIER
Active
Individual
JODY A DUGRENIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0561
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912983404
—
ME
05
—
3074821
—
NH
01
—
P00606562
MEDICARE RR
NH
Enumeration date
12/16/2005
Last updated
08/08/2023
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