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General NPI Number Information
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NPI Number | 1770260689
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Entity Type | Individual
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Provider Name | VENSON JEFFERSON TAYLOR JR. RN
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Gender | Male
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 370 JAMES ST
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City | NEW HAVEN
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State | CT
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Zip | 06513-3089
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Country | US
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Telephone | 203-874-6667
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Fax |
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Provider Business Mailing Address
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Address Line | 508 W TAFT AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-1826
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Country | US
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Telephone | 203-424-8349
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 110440
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License Number State | CT
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