Provider Demographics
NPI:1972327195
Name:PARE, JESSICA KIMBERLY (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:KIMBERLY
Last Name:PARE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-4001
Mailing Address - Country:US
Mailing Address - Phone:978-620-7575
Mailing Address - Fax:
Practice Address - Street 1:483 STEVENS ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-4001
Practice Address - Country:US
Practice Address - Phone:978-620-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2357623163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty