JESSICA KIBACK APRN NPI 1417414905

NPI Information

  • NPI: 1417414905
  • Provider Name: JESSICA KIBACK, APRN
  • Classification: Nurse Practitioner - 363LW0102X
  • Specialization: Women's Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 100 RETREAT AVE STE 201
    HARTFORD, CT
    ZIP 06106
  • Phone: (860) 246-8568

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NPI Details

Jessica Kiback, APRN is a women's health nurse practitioner in Hartford, CT. Jessica Kiback, APRN NPI is 1417414905. 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:

100 RETREAT AVE STE 201
HARTFORD, CT
ZIP 06106-528
Phone: (860) 246-8568
Fax: (860) 493-7798

The NPI 1417414905 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 2/21/2019 and was last updated on 12/16/2025.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LW0102XNurse PractitionerWomen's Health12.008136CALIFORNIANo
2363LW0102XNurse PractitionerWomen's Health8136CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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