Basic Information
| Provider Information | |||||||||
| NPI: | 1205816311 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIVERS | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 ASYLUM AVENUE | ||||||||
| Address2: | SUITE 2109A | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607145058 | ||||||||
| FaxNumber: | 8607148311 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 MAIN STREET | ||||||||
| Address2: | HARTFORD CITY TOWN HALL | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605438602 | ||||||||
| FaxNumber: | 8607228041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 09/05/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 238002 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 003530 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 363L00000X | 3530 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 3530 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.