Provider Demographics
NPI:1952076564
Name:SARKISIAN, JESSICA MARGARET (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARGARET
Last Name:SARKISIAN
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 1:17 HAMMOCK PKWY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2304
Mailing Address - Country:US
Mailing Address - Phone:860-304-3499
Mailing Address - Fax:
Practice Address - Street 1:317 FOXON RD
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-2038
Practice Address - Country:US
Practice Address - Phone:475-441-7809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner