Healthcare Provider Details

I. General information

NPI: 1093049868
Provider Name (Legal Business Name): JANET ZIMA HEATH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CHAPEL ST
NEW HAVEN CT
06511-4405
US

IV. Provider business mailing address

221 DINO RD
BRISTOL CT
06010-7890
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-3538
  • Fax:
Mailing address:
  • Phone: 860-214-3619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number082786
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: