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NPI Code Detail

MEDICARE: MS. SUSAN LEMELIN

MEDICARE: MS. SUSAN LEMELIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner8450CT

General Provider Information

NPI Number : 1265086706
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN LEMELIN
Provider Business Mailing Address
First Line : 17 S HIGHLAND ST
Second Line :
City : WEST HARTFORD
State : CT
Zip : 06119-1826
Country : US
Telephone Number : 860-258-4171
Fax Number :
Provider Business Practice Location Address
First Line : 14 WESTON ST
Second Line :
City : HARTFORD
State : CT
Zip : 06120-1504
Country : US
Telephone Number : 860-813-1113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2019
Last Update Date : 03/12/2026

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