Individual provider · Type 1 NPI
Kathryn E. Jack, APRN
Adult Health Nurse Practitioner · Meriden, CT
NPI number
1265456347
Active
Practice location
455 Lewis Ave, Suite 106
Meriden, CT 06451-2121
Fax (203) 886-0072
Mailing address
2139 Silas Deane Hwy
Rocky Hill, CT 06067-2336
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 002455 (CT) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 002455 (CT) |
| Family Nurse Practitioner | 363LF0000X | 002455 (CT) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1265456347
Kathryn E. Jack, APRN's National Provider Identifier is 1265456347, issued on Jul 26, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Meriden, CT. The record was last updated on Nov 5, 2013.