Jessie Louise Condon, APRN

Individual provider Active NPI Oncology Clinical Nurse Specialist · Derby, CT

NPI 1295989424 · NPPES record last updated Nov 14, 2008

Key facts

NPI
1295989424
Entity type
Individual (NPI type 1)
Primary specialty
Oncology Clinical Nurse Specialist 364SX0200X
License
003677 (CT)
Practice address
130 Division St
Derby, CT 06418-1326
Phone
(203) 732-7268
NPI assigned
Nov 14, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
003677CTMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinical Nurse Specialist 364SX0200X 003677 CT Yes

Addresses

Primary practice location

130 Division St
Derby, CT 06418-1326

Mailing address

130 Division St
Derby, CT 06418-1326
Phone (203) 732-7268

Other providers in Derby, CT

All providers in Derby, CT · Oncology Clinical Nurse Specialist in Connecticut

Sources for this page

Verify at the official NPI Registry.