Individual
JENNA A LOGIUDICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LNM
Contact information
Practice address
134 GRANDVIEW AVE, SUITE 210, WATERBURY, CT 06708-2507
(203) 754-2535
(203) 754-0788
Mailing address
134 GRANDVIEW AVE, SUITE 210, WATERBURY, CT 06708-2507
(203) 754-2535
(203) 754-0788
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
000319
CT
367A00000X
Advanced Practice Midwife
Primary
000319
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000319
CT NURSE MIDWIFE LICENSE
CT
Enumeration date
07/07/2008
Last updated
05/26/2015
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