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NPI 1962902536

NPI 1962902536 : JODY BIANCAMANO LYNCH MSN, FNP-BC : ROCKY HILL, CT

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General NPI Number Information
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    NPI Number           |    1962902536
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    Entity Type          |    Individual 
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    Provider Name        |    JODY BIANCAMANO LYNCH MSN, FNP-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/20/2018
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    Last Update Date     |    02/20/2018
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Provider Practice Location Address
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    Address Line         |    400 CAPITAL BLVD 
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    City                 |    ROCKY HILL
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    State                |    CT
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    Zip                  |    06067-3576
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    Country              |    US
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    Telephone            |    860-830-2473
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    157 STRADDLE HL 
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    City                 |    WETHERSFIELD
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    State                |    CT
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    Zip                  |    06109-2738
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    Country              |    US
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    Telephone            |    
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    7286
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    License Number State |    CT
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