NPI 1639061807 · live from the CMS NPI Registry
Jessica Anziano
Nurse Practitioner in Middletown, CT. National Provider Identifier 1639061807, active.
NPI record
| NPI | 1639061807 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 101 Centerpoint Dr Ste 300, Middletown, CT 06457 |
| Practice phone | 857-255-3315 |
| Mailing address | 101 Centerpoint Dr, Middletown, CT 06457 |
| Enumerated | July 21, 2025 |
| Last updated | July 21, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | 15002 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.