Provider Demographics
NPI:1528249331
Name:HILL, JENNIFER DARCY (RN, MSN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DARCY
Last Name:HILL
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:DARCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 COLUMBUS AVE
Mailing Address - Street 2:CREDENTIALING SPECIALIST
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1233
Mailing Address - Country:US
Mailing Address - Phone:203-503-3174
Mailing Address - Fax:203-503-3183
Practice Address - Street 1:635 MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2718
Practice Address - Country:US
Practice Address - Phone:860-347-6971
Practice Address - Fax:860-343-7379
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0042534363LP0200X
CT003647363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004236346Medicaid