Provider Demographics
NPI:1144342528
Name:NEU, JANE (APRN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:NEU
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 1:671 CHAFFEEVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06250
Mailing Address - Country:US
Mailing Address - Phone:860-786-8130
Mailing Address - Fax:
Practice Address - Street 1:6 LEDGEBROOK DR STE A
Practice Address - Street 2:
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1684
Practice Address - Country:US
Practice Address - Phone:860-456-1485
Practice Address - Fax:860-423-1589
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily