| Doctor Name: | MRS. JESSICA LYN CHAN |
| NPI Number: | 1174937114 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 94495 |
| Business Practice Address: | 682 East Main Street Branford, CT - 06405 |
| Business Phone Number: | 2034815591 |
| Business Fax Number: | 2034815594 |
| Mailing Address: | 999 Foxon Road, Suite 36 NORTH BRANFORD |
| State: | CT |
| Postal Code: | 06471 |
| Phone Number: | 2034847334 |
| Fax Number: | 2034847301 |
| NPI Enumeration Date: | 06/18/2014 |
| NPI Last Update Date: | 03/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | 94495 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |