Individual
JESSICA DEANNE YENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
50 FAIRE HARBOUR PL, NEW LONDON, CT 06320-4731
(860) 771-4960
Mailing address
99 HAWLEY LN FL CB34273, STRATFORD, CT 06614-1202
(203) 502-4650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28229593A
IN
207Q00000X
Family Medicine Physician
Primary
9211
CT
Other
Enumeration date
06/29/2020
Last updated
12/28/2021
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