Healthcare Provider Details

I. General information

NPI: 1083080998
Provider Name (Legal Business Name): JAMIE ELIZABETH KRZMARZICK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

764 CAMPBELL AVE STE E
WEST HAVEN CT
06516-3786
US

IV. Provider business mailing address

470 JAMES ST
NEW HAVEN CT
06513-3098
US

V. Phone/Fax

Practice location:
  • Phone: 203-931-0034
  • Fax: 203-931-8225
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12851
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: