Individual
JANE P GENIDO-TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,APRN
Contact information
Practice address
230 WATERFORD PKWY S, WATERFORD, CT 06385-1219
(860) 444-3744
Mailing address
230 WATERFORD PKWY S, WATERFORD, CT 06385-1219
(860) 444-3744
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
003887
CT
363LA2200X
Adult Health Nurse Practitioner
003887
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008003100
—
CT
01
—
803887
CONNECTICARE
CT
Enumeration date
10/14/2008
Last updated
04/18/2023
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