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MRS. JACLYN HELEN VINCENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
20 FELICITY LN, TORRINGTON, CT 06790-6101
(860) 496-0206
Mailing address
166 HARTLAND RD, WEST GRANBY, CT 06090-1109

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
5460
CT
363LP0200X
Pediatric Nurse Practitioner
Primary
005460
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008047268
CT
Enumeration date
09/25/2013
Last updated
08/06/2015
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