1023341369 NPI number — MISS JESSICA BURLINGTON HAMLIN RN, MS, CRNA

Table of content: MISS JESSICA BURLINGTON HAMLIN RN, MS, CRNA (NPI 1023341369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023341369 NPI number — MISS JESSICA BURLINGTON HAMLIN RN, MS, CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMLIN
Provider First Name:
JESSICA
Provider Middle Name:
BURLINGTON
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
RN, MS, CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DORSEY
Provider Other First Name:
JESSICA
Provider Other Middle Name:
BURLINGTON
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, MS, CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023341369
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 HOSPITAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06810-6099
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06810-6099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-739-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  5753 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)