Individual
JENNIFER CARISSA HANOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 ESSEX CENTER DR, 4TH FLOOR, PEABODY, MA 01960-2901
(978) 538-3600
(978) 538-3610
Mailing address
1 ESSEX CENTER DRIVE, 4TH FLOOR, PEABODY, MA 01960
(978) 538-3600
(978) 538-3610
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
829
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110100179A
—
MA
Enumeration date
10/26/2006
Last updated
12/12/2014
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