Nelson, Jill T

Nelson, Jill T is an individual health care provider with primary practice located at 421 Cottage Grove Rd Suite A, Bloomfield CT 06002-3119. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Nelson, Jill T can be contacted via phone (860) 242-3393.

Contact Information

Primary practice address
421 Cottage Grove Rd Suite A Bloomfield CT 06002-3119
Phone: (860) 242-3393
Fax: (860) 242-3301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 001331 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 001331 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1331 Connecticut

Profile Details

NPI number 1164493243
LBN Legal business name Nelson, Jill T
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Oct 4th, 2013 - about 11 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 1164493243 NPPES
Connecticut Other 400001331CT04 ANTHEM BLUE SHIELD
Connecticut Other 010331 ANTHEM BLUE SHIELD
Connecticut Other 2V4369 ANTHEM BLUE SHIELD
Connecticut MEDICAID 004195039 ANTHEM BLUE SHIELD

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