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JENNA WOODALL BOURGEOIS
NPI 1366176083
Nurse Practitioner - Women's Health in Deep River, CT

Active since July 11, 2022
124 MAIN ST # 2, DEEP RIVER, CT 06417(860) 526-1756 Get Directions Write a Review

NPPES record last updated: July 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jenna Woodall Bourgeois NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNA WOODALL BOURGEOIS (NPI 1366176083) is an individual women's health provider in Deep River, Connecticut, licensed in Connecticut (12.010268) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1366176083
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameJENNA WOODALL BOURGEOIS
Location Address124 MAIN ST # 2Deep River, CT 06417-1756
Mailing Address156 Willow St Apt 1New Haven, CT 06511-2673 · (203) 249-1361
Phone(860) 526-1756
Sole ProprietorNo
Enumeration DateJuly 11, 2022
NPPES CertifiedMay 24, 2022
✔ NPI 1366176083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in CT · 12.010268
124 MAIN ST # 2, Deep River, CT 06417
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jenna Bourgeois's NPI number?

The NPI number for Jenna Bourgeois is 1366176083. It was assigned to this individual provider in the NPPES registry on July 11, 2022.

Where is Jenna Bourgeois located?

Jenna Bourgeois practices at 124 Main St # 2, Deep River, CT 06417. The listed phone number is (860) 526-1756.

What is Jenna Bourgeois's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

When was this NPI record last updated?

The NPPES record for Jenna Bourgeois was last updated on July 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.