Provider Demographics
NPI:1962734426
Name:MCINTYRE, JENNIFER (CRNA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-0655
Mailing Address - Country:US
Mailing Address - Phone:603-580-6624
Mailing Address - Fax:603-580-6620
Practice Address - Street 1:5 ALUMNI DR
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2128
Practice Address - Country:US
Practice Address - Phone:603-778-6624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH061957-23367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered