Provider Demographics
NPI:1205458809
Name:SEGALLA, JEAN-A'LAYN (DNP, MSN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:JEAN-A'LAYN
Middle Name:
Last Name:SEGALLA
Suffix:
Gender:F
Credentials:DNP, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 ASPEN GLEN DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-5315
Mailing Address - Country:US
Mailing Address - Phone:203-502-9808
Mailing Address - Fax:
Practice Address - Street 1:439 MILL HILL AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2866
Practice Address - Country:US
Practice Address - Phone:203-334-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.008979363LF0000X
CT119335163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse