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General NPI Number Information
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NPI Number | 1992501290
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Entity Type | Individual
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Provider Name | JEAN PAULA YACELGA APRN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 966 S MAIN ST
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City | PLANTSVILLE
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State | CT
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Zip | 06479-1645
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Country | US
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Telephone | 860-736-5386
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Fax |
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Provider Business Mailing Address
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Address Line | 720 KETTLETOWN RD
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City | SOUTHBURY
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State | CT
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Zip | 06488-4628
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Country | US
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Telephone | 203-592-1602
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Fax | 860-590-3921
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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 | 014481
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License Number State | CT
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