Provider Demographics
NPI:1679923775
Name:APPLETON, JENYA (CNP)
Entity type:Individual
Prefix:
First Name:JENYA
Middle Name:
Last Name:APPLETON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NH
Mailing Address - Zip Code:03858-3107
Mailing Address - Country:US
Mailing Address - Phone:978-273-0488
Mailing Address - Fax:
Practice Address - Street 1:55 HIGHLAND AVE STE 304
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2100
Practice Address - Country:US
Practice Address - Phone:978-354-4611
Practice Address - Fax:978-354-4651
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily