MEDICARE: DR. JENNIFER V KREBS ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	000267	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110000267CT01	OTHER	CT	ANTHEM BCBS

General Provider Information

NPI Number	:	1407920994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER V KREBS ND

Provider Business Mailing Address
First Line	:	26 TRUMBULL STREET
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-6301
Country	:	US
Telephone Number	:	203-776-1212
Fax Number	:	203-776-1213

Provider Business Practice Location Address
First Line	:	26 TRUMBULL STREET
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-6301
Country	:	US
Telephone Number	:	203-776-1212
Fax Number	:	203-776-1213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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