Provider Demographics
NPI:1164997334
Name:MCLAUGHLIN, JENNY REBECCA AMY (CNM)
Entity type:Individual
Prefix:
First Name:JENNY REBECCA
Middle Name:AMY
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:139 PLYMOUTH ST APT 405B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-8340
Mailing Address - Country:US
Mailing Address - Phone:917-604-8475
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2025-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY814314367A00000X
NY002337367A00000X
VT1010137151367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty