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General NPI Number Information
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NPI Number | 1134661531
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Entity Type | Individual
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Provider Name | JENNIFER MARIA SOUSA JEROME APRN
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Gender | Female
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Dates
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Enumeration Date | 11/16/2016
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 281 HARTFORD TPKE STE 106
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City | VERNON
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State | CT
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Zip | 06066-4760
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Country | US
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Telephone | 860-375-2227
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Fax | 860-603-5080
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Provider Business Mailing Address
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Address Line | 281 HARTFORD TPKE STE 106
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City | VERNON
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State | CT
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Zip | 06066-4760
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Country | US
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Telephone | 860-375-2227
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Fax | 860-603-5080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 6811
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License Number State | CT
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