Individual
MS. JENNIFER R MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2444 E MAIN RD, PORTSMOUTH, RI 02871-4025
(401) 683-4817
Mailing address
200 MILL RD, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
335104
NY
363L00000X
Nurse Practitioner
Primary
APRN01824
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02892840
—
NY
Enumeration date
04/25/2007
Last updated
09/06/2024
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