Individual
JENNELLE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
326 NICHOLS RD, FITCHBURG, MA 01420-1914
(978) 878-8100
Mailing address
326 NICHOLS RD, FITCHBURG, MA 01420-1914
(978) 878-8100
(978) 878-8535
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN2298593
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2298593
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303007
—
MA
Enumeration date
03/18/2016
Last updated
11/05/2025
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