Provider Demographics
NPI:1407920994
Name:KREBS, JENNIFER V (ND)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:V
Last Name:KREBS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 TRUMBULL STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-6301
Mailing Address - Country:US
Mailing Address - Phone:203-776-1212
Mailing Address - Fax:203-776-1213
Practice Address - Street 1:26 TRUMBULL STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6301
Practice Address - Country:US
Practice Address - Phone:203-776-1212
Practice Address - Fax:203-776-1213
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000267175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT110000267CT01OtherANTHEM BCBS