Provider Demographics
NPI:1366886376
Name:QUAGLINI, JENNIFER (LPN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:QUAGLINI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CITY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4120
Mailing Address - Country:US
Mailing Address - Phone:413-562-0329
Mailing Address - Fax:413-480-6811
Practice Address - Street 1:112 CITY VIEW RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4120
Practice Address - Country:US
Practice Address - Phone:413-562-0329
Practice Address - Fax:413-480-6811
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN69544164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse