Individual
JENNIFER L MULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6394
(860) 358-6748
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6394
(860) 358-6748
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
108351
CT
363L00000X
Nurse Practitioner
C089082
IA
363LN0000X
Neonatal Nurse Practitioner
Primary
005180
CT
363LN0000X
Neonatal Nurse Practitioner
K089082
IA
363LP0200X
Pediatric Nurse Practitioner
005180
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421040
—
IA
01
—
31674
WELLMARK BCBS
IA
Enumeration date
09/22/2005
Last updated
12/10/2012
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