Individual
JAIMEE TAYLOR DIZENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
249 SPRING LAKE RD, SOUTHINGTON, CT 06489-4426
(860) 681-1646
Mailing address
249 SPRING LAKE RD, SOUTHINGTON, CT 06489-4426
(860) 681-1646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12251
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2023
Last updated
08/30/2023
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