Individual
JILL T NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
421 COTTAGE GROVE RD, SUITE A, BLOOMFIELD, CT 06002-3119
(860) 242-3393
(860) 242-3301
Mailing address
421 COTTAGE GROVE RD, SUITE A, BLOOMFIELD, CT 06002-3119
(860) 242-3393
(860) 242-3301
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
001331
CT
363LA2200X
Adult Health Nurse Practitioner
001331
CT
363LF0000X
Family Nurse Practitioner
Primary
1331
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004195039
—
CT
01
—
010331
CONNECTICARE
CT
01
—
2V4369
HEALTHNET
CT
01
—
400001331CT04
ANTHEM BLUE SHIELD
CT
Enumeration date
01/27/2006
Last updated
10/04/2013
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