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General NPI Number Information
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NPI Number | 1568552826
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Entity Type | Individual
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Provider Name | JASON STRICKLAND APRN
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Gender | Male
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 22 PINE ST SUITE 104
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City | BRISTOL
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State | CT
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Zip | 06010-6948
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Country | US
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Telephone | 860-584-8291
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Fax | 860-584-8354
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Provider Business Mailing Address
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Address Line | 22 PINE ST SUITE 104
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City | BRISTOL
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State | CT
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Zip | 06010-6948
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Country | US
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Telephone | 860-584-8291
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Fax | 860-584-8354
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 005510
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5510
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5510
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License Number State | CT
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