Basic Information
| Provider Information | |||||||||
| NPI: | 1619959988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HESS | ||||||||
| FirstName: | JACQUELINE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 5TH ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029063760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012732356 | ||||||||
| FaxNumber: | 4012738913 | ||||||||
| Practice Location | |||||||||
| Address1: | 2005 BAY ST | ||||||||
| Address2: | OCCUPATIONAL HEALTH SERVICE | ||||||||
| City: | TAUNTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027801085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088240242 | ||||||||
| FaxNumber: | 5088281810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2005 | ||||||||
| LastUpdateDate: | 10/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 5838 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2083P0500X | 44882 | MA | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine |
No ID Information.