Provider Demographics
NPI:1386877355
Name:STEWART, JILL ALLISON (APRN)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ALLISON
Last Name:STEWART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:ALLISON
Other - Last Name:PINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 OLD DUCK HOLE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2504
Mailing Address - Country:US
Mailing Address - Phone:203-245-7095
Mailing Address - Fax:
Practice Address - Street 1:100 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4150363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care