Jenna Woodall Bourgeois, is a
Nurse Practitioner - Women's Health based in Deep River, Connecticut. Jenna Woodall Bourgeois is licensed to practice in Connecticut (license number 12.010268) and her current practice location is
124 Main St # 2, Deep River, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 526-1756.
NPI number for Jenna Woodall Bourgeois is 1366176083 and her current mailing address is 156 Willow St Apt 1, New Haven, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366176083.
Provider's Profile
Full Name | Jenna Woodall Bourgeois |
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Gender | Female |
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Speciality | Nurse Practitioner - Women's Health |
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Location | 124 Main St # 2, Deep River, Connecticut |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1366176083
- Provider Enumeration Date: 07/11/2022
- Last Update Date: 07/11/2022
Medical Identifiers
Medical identifiers for Jenna Woodall Bourgeois such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1366176083 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LW0102X | Nurse Practitioner - Women's Health | 12.010268 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jenna Woodall Bourgeois is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jenna Woodall Bourgeois, 156 Willow St Apt 1, New Haven, CT 06511-2673 Ph: (203) 249-1361 | Jenna Woodall Bourgeois, 124 Main St # 2, Deep River, CT 06417-1756 Ph: (860) 526-1756 |
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