Individual
JESSICA LEIGH NIVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
388 W CENTER ST, MANCHESTER, CT 06040-4735
(860) 649-1120
Mailing address
388 W CENTER ST, MANCHESTER, CT 06040-4735
(860) 649-1120
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
16.000511
CT
367A00000X
Advanced Practice Midwife
Primary
511
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16.000511
CT CNM LICENSE
CT
Enumeration date
04/25/2022
Last updated
01/20/2026
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