Jennifer Detlefsen, ATC, MHA
Specialist/Technologist, Athletic Trainer in Bethlehem, Connecticut
1053825067- Practice location
- 57 Long Meadow RD, Bethlehem, CT 06751-1116
- Phone
- 203-405-3369
- Fax
- —
- Last updated
- November 29, 2017
Jennifer Detlefsen is a Specialist/Technologist, Athletic Trainer based in Bethlehem, CT. Jennifer Detlefsen practices in Bethlehem, CT and has the professional credentials of ATC, MHA. The NPI Number for Jennifer Detlefsen is 1053825067 and holds a License No. 764 (CT). The current practice location address for Jennifer Detlefsen is 57 Long Meadow RD, Bethlehem, CT 06751-1116 and can be reached out via phone at 203-405-3369.
Provider Profile Details
- NPI Number
- 1053825067
- Provider Name
- Jennifer Detlefsen
- Credential
- ATC, MHA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 57 Long Meadow RD, Bethlehem, CT 06751-1116
- Phone Number
- 203-405-3369
- Primary Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- November 29, 2017
- Last Update Date
- November 29, 2017
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 57 Long Meadow RD
Bethlehem, CT 06751-1116 - City
- Bethlehem
- State
- Connecticut
- Zip
- 06751-1116
- Phone Number
- 203-405-3369
Provider Business Mailing Address Details
- Address
- 57 Long Meadow RD
Bethlehem, CT 06751-1116 - City
- Bethlehem
- State
- CT
- Zip
- 06751-1116
- Phone Number
- 203-405-3369
License Information
- License Number
- 764
- License State
- CT
- Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jennifer Detlefsen, ATC, MHA?
The NPI number of Jennifer Detlefsen, ATC, MHA is 1053825067. It was assigned on November 29, 2017 and is currently active in the NPPES registry.
What is the specialty of Jennifer Detlefsen, ATC, MHA?
Jennifer Detlefsen, ATC, MHA is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X), licensed in CT under license number 764.
Where does Jennifer Detlefsen, ATC, MHA practice?
The practice location is 57 Long Meadow RD, Bethlehem, CT 06751-1116. The office can be reached at 203-405-3369 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1053825067 directly on the NPPES registry website.