Provider Demographics
NPI:1508539024
Name:HEALY, JANYNA AQUIJE (APRN)
Entity Type:Individual
Prefix:
First Name:JANYNA
Middle Name:AQUIJE
Last Name:HEALY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 E MAIN ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3136
Mailing Address - Country:US
Mailing Address - Phone:034-887-2282
Mailing Address - Fax:
Practice Address - Street 1:240 INDIAN RIVER RD STE A5
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3690
Practice Address - Country:US
Practice Address - Phone:203-799-1252
Practice Address - Fax:203-799-3252
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9826363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care