KATHRYN E JACK APRN NPI 1265456347

NPI Information

Kathryn E Jack, APRN is an adult health nurse practitioner in Meriden, CT with 24 years of experience. Kathryn E Jack, APRN NPI is 1265456347. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

455 LEWIS AVE
SUITE 106
MERIDEN, CT
ZIP 06451-121
Phone: (203) 886-0036
Fax: (203) 886-0072

The NPI 1265456347 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 11/5/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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