Mrs. Jessica L Chan, APRN
Nurse Practitioner, Pediatrics in New London, Connecticut
1174937114- Practice location
- 74 Grove St, New London, CT 06320-6515
- Phone
- 860-447-6070
- Fax
- 860-443-6616
- Last updated
- September 10, 2018
Jessica Lyn Chan is a Nurse Practitioner, Pediatrics based in New London, CT. Jessica Lyn Chan practices in New London, CT and has the professional credentials of APRN. The NPI Number for Jessica Lyn Chan is 1174937114 and holds a License No. 5804 (CT). The current practice location address for Jessica Lyn Chan is 74 Grove St, New London, CT 06320-6515 and can be reached out via phone at 860-447-6070 and via fax at 860-443-6616.
Provider Profile Details
- NPI Number
- 1174937114
- Provider Name
- Jessica Lyn Chan
- Credential
- APRN
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 74 Grove St, New London, CT 06320-6515
- Phone Number
- 860-447-6070
- Fax Number
- 860-443-6616
- Primary Taxonomy
- Nurse Practitioner, Pediatrics · 363LP0200X
- Sole Proprietor
- Yes
- Other Names
- Miss Jessica Lyn Davis, APRN (Former Name)
- Provider Enumeration Date
- June 18, 2014
- Last Update Date
- September 10, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 74 Grove St
New London, CT 06320-6515 - City
- New London
- State
- Connecticut
- Zip
- 06320-6515
- Phone Number
- 860-447-6070
- Fax Number
- 860-443-6616
Provider Business Mailing Address Details
- Address
- 999 Foxon Road
Suite 36
North Branford, CT 06471 - City
- North Branford
- State
- CT
- Zip
- 06471
- Phone Number
- 203-484-7334
- Fax Number
- 203-484-7301
License Information
- License Number (1)
- 5804
- License State (1)
- CT
- Taxonomy (1)
- Nurse Practitioner, Pediatrics · 363LP0200X · Primary
- License Number (2)
- 94495
- License State (2)
- CT
- Taxonomy (2)
- Registered Nurse, Pediatrics · 163WP0200X
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 Mrs. Jessica L Chan, APRN?
The NPI number of Mrs. Jessica L Chan, APRN is 1174937114. It was assigned on June 18, 2014 and is currently active in the NPPES registry.
What is the specialty of Mrs. Jessica L Chan, APRN?
Mrs. Jessica L Chan, APRN is registered under the primary taxonomy Nurse Practitioner, Pediatrics (code 363LP0200X), licensed in CT under license number 5804.
Where does Mrs. Jessica L Chan, APRN practice?
The practice location is 74 Grove St, New London, CT 06320-6515. The office can be reached at 860-447-6070 (phone) or 860-443-6616 (fax).
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 1174937114 directly on the NPPES registry website.