Bacon, Jessica A

Bacon, Jessica A is an individual health care provider with primary practice located at 2300 Southwood Dr Dartmouth Hitchcock - Ob/Gyn, Nashua NH 03063. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Bacon, Jessica A can be contacted via phone (603) 577-3407.

Contact Information

Primary practice address
2300 Southwood Dr Dartmouth Hitchcock - Ob/Gyn Nashua NH 03063
Phone: (603) 577-3407
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 12100354 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 048175-23 New Hampshire

Profile Details

NPI number 1053663880
LBN Legal business name Bacon, Jessica A
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2012
Last updated Jun 5th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053663880 NPPES
New Hampshire Other 1578854287 GROUP NPI
New Hampshire MEDICAID 3081928 GROUP NPI

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