Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathryn E Jack, APRN

Individual provider Nurse Practitioner · NPI 1265456347

Kathryn E Jack, APRN is a Nurse Practitioner in Meriden, Connecticut. Qualified in 2000, 26 years ago. Practices with Connecticut Gi PLLC, a 245-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
26
Licensed in
CT
In the registry since
2006
Specialties on file
3
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

455 Lewis Ave Ste 106
Meriden, CT 06451-2121
Phone: (203) 886-0036
Fax: (203) 886-0072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 002455 (CT)
Nurse Practitioner Taxonomy 363L00000X · Licence 002455 (CT)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 002455 (CT)

Record details

NPI number1265456347
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorNo
NPI enumeratedJuly 26, 2006
Last updated in NPPESNovember 5, 2013
Mailing address2139 Silas Deane Hwy, Rocky Hill, CT 06067-2336

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Connecticut Gi Pllc — 245 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Meriden