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Individual

JENNA BOUTILIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
106 NATE WHIPPLE HWY, SUITE 101, CUMBERLAND, RI 02864-1403
(401) 658-2020
(401) 658-3612
Mailing address
PO BOX 27, MANVILLE, RI 02838-0027
(800) 927-0002

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NPP37529
RI

Other

Enumeration date
10/22/2009
Last updated
10/22/2009
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