Basic Information
| Provider Information | |||||||||
| NPI: | 1467836254 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POILLUCCI | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | CNP, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1559 BAY ST APT 48 | ||||||||
| Address2: | |||||||||
| City: | TAUNTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027801049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084721057 | ||||||||
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| Practice Location | |||||||||
| Address1: | 88 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | TAUNTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02780 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088287000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2015 | ||||||||
| LastUpdateDate: | 10/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN216727 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.