Braunworth, Jacqueline

Braunworth, Jacqueline is an individual health care provider with primary practice located at 68 Division St , Derby CT 06418-1447. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Braunworth, Jacqueline can be contacted via phone (203) 732-6802.

Contact Information

Primary practice address
68 Division St Derby CT 06418-1447
Phone: (203) 732-6802
Fax: (203) 732-6792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003273 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 003273 Connecticut

Profile Details

NPI number 1649665936
LBN Legal business name Braunworth, Jacqueline
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2015
Last updated Oct 19th, 2022 - 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 1649665936 NPPES
Connecticut MEDICAID 1649665936

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