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General NPI Number Information
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NPI Number | 1780337154
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Entity Type | Individual
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Provider Name | JENNIFER LYNN SHELTON MSN, APRN, AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 100 GRAND ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-2016
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Country | US
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Telephone | 860-259-7168
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Fax |
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Provider Business Mailing Address
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Address Line | 158 PADDOCK AVE. UNIT 202
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City | MERIDEN
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State | CT
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Zip | 06450-6973
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Country | US
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Telephone | 203-213-2485
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 10104
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License Number State | CT
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