De Thouars, Jung Mi
De Thouars, Jung Mi is an individual health care provider with primary practice located at 40 Mansfield Ave , Willimantic CT 06226-2018. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. De Thouars, Jung Mi can be contacted via phone (860) 450-7471.Contact Information
Primary practice address
40 Mansfield Ave
Willimantic CT 06226-2018
Phone: (860) 450-7471
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 138693 | Connecticut |
Profile Details
| NPI number | 1699239293 |
|---|---|
| LBN Legal business name | De Thouars, Jung Mi |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 28th, 2019 |
| Last updated | Apr 12th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699239293 | NPPES |
| Connecticut | MEDICAID | 138693 |
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