Nicholson, Janis M

Nicholson, Janis M is an sole proprietor health care provider with primary practice located at 278 Goodale Drive , Newington CT 06111-3131. 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. Nicholson, Janis M can be contacted via phone (860) 667-0665.

Contact Information

Primary practice address
278 Goodale Drive Newington CT 06111-3131
Phone: (860) 667-0665
Fax: (860) 667-0665
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN 000804 Connecticut

Profile Details

NPI number 1700952413
LBN Legal business name Nicholson, Janis M
Credentials MA,APRN,CS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 27th, 2006
Last updated Jun 17th, 2008 - about 18 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 1700952413 NPPES
Connecticut Other 400000804CT02 ANTHEM BCBS

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