| Doctor Name: | MS. JENNIFER ANNE GANEM |
| NPI Number: | 1255340469 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, APRN |
| License Number: | 0374162308 |
| Business Practice Address: | 50 Nashua Rd Ste 208 Londonderry Square Londonderry, NH - 030533438 |
| Business Phone Number: | 6034323399 |
| Business Fax Number: | 6034323396 |
| Mailing Address: | 50 Nashua Rd Ste 208, Londonderry Square LONDONDERRY |
| State: | NH |
| Postal Code: | 030533438 |
| Phone Number: | 6034323399 |
| Fax Number: | 6034323396 |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 11/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 0374162308 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |