Individual
JACQUELYN PENTA KILMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL OB/GYN DEPT, HARTFORD, CT 06102-5037
(860) 972-2780
Mailing address
P.O. BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
002762
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004249042
—
CT
Enumeration date
09/28/2006
Last updated
05/21/2012
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