Martin, Jacqueline C

Martin, Jacqueline C is an individual health care provider with primary practice located at 26 Chamberlain Hwy , Kensington CT 06037-1921. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Martin, Jacqueline C can be contacted via phone (860) 893-0040.

Contact Information

Primary practice address
26 Chamberlain Hwy Kensington CT 06037-1921
Phone: (860) 893-0040
Fax: (860) 893-0046
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 005215 Connecticut

Profile Details

NPI number 1306180542
LBN Legal business name Martin, Jacqueline C
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2012
Last updated May 26th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306180542 NPPES
Connecticut MEDICAID 008042980

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