NPI 1649725656 · live from the CMS NPI Registry
Jenna Addison
Nurse Practitioner, Family in Trumbull, CT. National Provider Identifier 1649725656, active.
NPI record
| NPI | 1649725656 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 5520 Park Ave, Trumbull, CT 06611 |
| Practice phone | 203-337-8790 |
| Mailing address | 5520 Park Avenue, Trumbull, CT 06611 |
| Enumerated | August 19, 2016 |
| Last updated | June 20, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 102579 (CT) |
| Nurse Practitioner, Family primary | 363LF0000X | 6670 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.