MEDICARE: JENNIFER MONAHAN

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	363LF0000X	Family Nurse Practitioner	15238	CT

General Provider Information

NPI Number	:	1801758552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MONAHAN

Provider Business Mailing Address
First Line	:	38 HALEY MEADOW RD
Second Line	:
City	:	GRISWOLD
State	:	CT
Zip	:	06351-1155
Country	:	US
Telephone Number	:	860-617-6699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 NORTHWESTERN DR STE 101
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3400
Country	:	US
Telephone Number	:	860-249-4862
Fax Number	:	860-760-5719

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ JENNIFER MONAHAN ” Practice Location

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