Healthcare Provider Details

I. General information

NPI: 1306767710
Provider Name (Legal Business Name): JENNIFER GANOE MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 HAWLEY LN STE 1102
STRATFORD CT
06614-1204
US

IV. Provider business mailing address

99 HAWLEY LN STE 1102
STRATFORD CT
06614-1204
US

V. Phone/Fax

Practice location:
  • Phone: 203-666-8145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042615
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: