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Organization

JESSICA VAN RYE APRN FNP BC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA HANLON VAN RYE APRN (OWNER)
(860) 892-8012
Entity
Organization

Contact information

Practice address
620 NORWICH NEW LONDON TPKE, UNCASVILLE, CT 06382-2121
(860) 892-8012
(860) 892-8027
Mailing address
620 NORWICH NEW LONDON TPKE, UNCASVILLE, CT 06382-2121
(860) 334-3893
(860) 892-8027

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
002779
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004229276
CT
Enumeration date
08/11/2017
Last updated
08/11/2017
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