Individual
MS. JACQUELYN ELISE PENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 LYONS ST, DEDHAM, MA 02026-5599
(508) 880-0012
Mailing address
1 LYONS STREET, ATRIUS HEALTH, INC, BOSTON, MA 02026
(617) 657-6495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5064
MA
Other
Enumeration date
07/14/2014
Last updated
09/13/2021
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