Basic Information
Provider Information
NPI: 1699002618
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JEAN-NOEL
FirstName: NATACHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
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Mailing Information
Address1: 1000 ASYLUM AVE
Address2: SUITE 2109A
City: HARTFORD
State: CT
PostalCode: 061051770
CountryCode: US
TelephoneNumber: 8607146581
FaxNumber: 8607148311
Practice Location
Address1: 1000 ASYLUM AVE
Address2: SUITE 2102
City: HARTFORD
State: CT
PostalCode: 061051770
CountryCode: US
TelephoneNumber: 8607147509
FaxNumber: 8607148238
Other Information
ProviderEnumerationDate: 11/11/2009
LastUpdateDate: 05/31/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600XARNP 3421172FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
363LP2300XARNP 3421172FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
363L00000X4991CTY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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