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Individual

JACQUELINE ELISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
400 W CAMPUS DR, ORANGE, CT 06477-3646
(612) 298-3241
Mailing address
400 W CAMPUS DR, ORANGE, CT 06477-3646
(612) 298-3241

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
15039
CT

Other

Enumeration date
02/21/2019
Last updated
12/11/2025
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