Provider Demographics
NPI:1760683114
Name:DOHERTY, JENNIFER E (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:DOHERTY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:3 NASHUA RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5515
Practice Address - Country:US
Practice Address - Phone:603-472-6700
Practice Address - Fax:603-472-6701
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH057051-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily