JESSICA PETRUSKA APRN NPI 1619854965

NPI Information

  • NPI: 1619854965
  • Provider Name: JESSICA PETRUSKA, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 263 FARMINGTON AVE
    FARMINGTON, CT
    ZIP 06030
  • Phone: (860) 679-4100

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NPI Details

Jessica Petruska, APRN is a family nurse practitioner in Farmington, CT with 1 years of experience. Jessica Petruska, APRN NPI is 1619854965. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduation Year:2025

The provider's business location address is:

263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030-036
Phone: (860) 679-4100
Fax: (860) 679-3385

The NPI 1619854965 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 8/19/2025 and was last updated on 9/16/2025.

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
1363LF0000XNurse PractitionerFamily12.015030CONNECTICUTYes

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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