Dilworth, Jeannie

Dilworth, Jeannie is an sole proprietor health care provider with primary practice located at 925 Sullivan Ave Unit 2, South Windsor CT 06074-2025. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Dilworth, Jeannie can be contacted via phone (860) 432-7771.

Contact Information

Primary practice address
925 Sullivan Ave Unit 2 South Windsor CT 06074-2025
Phone: (860) 432-7771
Fax: (860) 432-7774
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 001987 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 001987 Connecticut

Profile Details

NPI number 1265487425
LBN Legal business name Dilworth, Jeannie
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2006
Last updated Jul 1st, 2015 - 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 1265487425 NPPES
Connecticut MEDICAID 004253407

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