Jennifer Hettrick, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

084305 Issued in CT

Practice address

134 State St
Meriden, CT 06450-3293

Phone

(203) 237-2229

Fax

(203) 686-1677

NPI assigned

Nov 4, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1861645848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MAIN ST",
            "address_2": "ATTN: CREDENTIALING DEPT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 STATE ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503293",
            "telephone_number": "203-237-2229",
            "fax_number": "203-686-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTRICK",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "084305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Meriden, CT
• Providers in Meriden, CT by specialty
• Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.