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Individual

JACQUELYN BASILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 BEARD SAWMILL RD, SHELTON, CT 06484-6150
(203) 452-8322
Mailing address
100 BEARD SAWMILL RD, SHELTON, CT 06484-6150

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
15059
CT

Other

Enumeration date
07/10/2025
Last updated
07/10/2025
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