Individual
JEANNIE DILWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
642 HILLIARD ST STE 1315, MANCHESTER, CT 06042-2700
(860) 335-7221
(833) 901-3911
Mailing address
642 HILLIARD ST STE 1315, MANCHESTER, CT 06042-2700
(860) 335-6834
(833) 901-3911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
001987
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
001987
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004253407
—
CT
Enumeration date
05/24/2006
Last updated
07/27/2025
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