Provider Demographics
NPI:1992913453
Name:HILBERT, JENNIFER L (MED, ATC, EMT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:HILBERT
Suffix:
Gender:F
Credentials:MED, ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LAMPHIRE LANE
Mailing Address - Street 2:NA
Mailing Address - City:LYME
Mailing Address - State:NH
Mailing Address - Zip Code:03768
Mailing Address - Country:US
Mailing Address - Phone:603-359-5252
Mailing Address - Fax:
Practice Address - Street 1:41 LEBANON ST
Practice Address - Street 2:ATHLETIC DEPT
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755
Practice Address - Country:US
Practice Address - Phone:603-643-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer