Individual
JEWEL WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
966 S MAIN ST, PLANTSVILLE, CT 06479-1645
(860) 863-1001
Mailing address
110 OSBORN AVE, NEW HAVEN, CT 06511-2804
(475) 238-0639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
128640
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12361
CT
Other
Enumeration date
08/07/2023
Last updated
10/31/2023
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