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Contact Information

JACQUELINE M FENNERTY, DPM
1435 G ST
SPRINGFIELD, OR97477-4113
 Phone: 541-735-9420
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JACQUELINE M FENNERTY · (Female)

NPI # 1992871495
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 11/27/2006
Last updated 01/14/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • OR License # DP00292
  • OR Medicaid 150584
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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