Provider Demographics
NPI:1548630106
Name:KILGORE, JENNIFER ANNE (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:KILGORE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:KILGORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:379 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1226
Mailing Address - Country:US
Mailing Address - Phone:603-236-7693
Mailing Address - Fax:480-582-0441
Practice Address - Street 1:0 PROFILE CIR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1716
Practice Address - Country:US
Practice Address - Phone:603-236-7693
Practice Address - Fax:480-582-0441
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH132175F00000X, 175F00000X
AZ15-1511175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath