JESSICA KIBACK (NPI# 1417414905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417414905 |
| Entity Type | Individual |
| Full Name | JESSICA KIBACK |
| Credential | APRN |
| Practice Address |
100 Retreat Ave Ste 201 Hartford CT 06106-2528 |
| Practice Telephone | 8602468568 |
| Practice Fax Number | 8604937798 |
| Mailing Telephone | 8602468568 |
| Mailing Fax Number | 8604937798 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
8136 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 399 Farmington Ave Ste 230, Farmington, CT 060321944 | 8602468568 | 8604937798 |
| 148 Eastern Blvd Ste 100, Glastonbury, CT 060334321 | 8602468568 | 8604937798 |
| 1084 Cromwell Ave, Rocky Hill, CT 060673445 | 8602468568 | 8604937798 |
| Street Address |
100 RETREAT AVE STE 201 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106-2528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952833394 | Kulwinder Nicole Bajwa | Nurse Practitioner | 1075 Asylum Ave Fl 1, Hartford, CT 06105-2455 | 2017-04-03 |
| 1790238020 | Colleen Taylor | Nurse Practitioner | 21 Grand St, Hartford, CT 06106-1541 | 2016-08-03 |
| 1619376084 | Janet Mule | Nurse Practitioner | 500 Albany Ave, Hartford, CT 06120-2508 | 2014-08-21 |
| 1770666547 | Mary Ann Pianka | Nurse Practitioner | 80 Seymour Street, Hartford Hospital Ob/gyn, Hartford, CT 06102 | 2006-10-23 |
| 1962582874 | Dolores A Lynch | Nurse Practitioner | 80 Seymour Street, Hartford Hospital Ob/gyn, Hartford, CT 06102 | 2006-10-16 |
| 1417045055 | Mary-ellen A. Gonci | Nurse Practitioner | 80 Seymour Street, Hartford Hospital Ob/gyn Dept, Hartford, CT 06102 | 2006-10-10 |
| 1851499024 | Donna D. Steffen | Nurse Practitioner | 1229 Albany Ave, Hartford, CT 06112-2132 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073977591 | Megan Monteiro | Nurse Practitioner | 120 Park Lane Rd # 202, New Milford, CT 06776-2444 | 2016-04-11 |
| 1346609955 | Monika Magdalena Sullivan | Nurse Practitioner | 122 Maple Street, Bristol, CT 06010 | 2016-02-11 |
| 1578962528 | Chloe Quinn | Nurse Practitioner | 1030 New Britain Avenue, West Hartford, CT 06110-2261 | 2014-08-15 |
| 1578985032 | Cynthia A. Ely I | Nurse Practitioner | 30 Deepwood Rd, Wilton, CT 06897-4201 | 2014-01-16 |
| 1578775953 | Lorna Cassidy Aliperti | Nurse Practitioner | 236 Stamford Ave, Stamford, CT 06902-8233 | 2007-05-05 |
| 1760502397 | Kristen Maria Stehle | Nurse Practitioner | 4 Shaws Cv Ste 105, New London, CT 06320-4956 | 2007-03-29 |
| 1164446878 | Patricia A Labowsky | Nurse Practitioner | 415 Howe Ave, Shelton, CT 06484-3166 | 2006-07-26 |
| 1164458386 | Shawn Polizzi | Nurse Practitioner | 1090 Main St, Branford, CT 06405-3716 | 2006-06-23 |
| 1710943444 | Janet Marie Fischer | Nurse Practitioner | 105 West Rd, Ellington, CT 06029-5700 | 2006-04-21 |
| 1124016357 | Cheri Margo Brady | Nurse Practitioner | 388 W Center St, Manchester, CT 06040-4735 | 2005-10-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.