MEDICARE: SHARON COLWELL APRN

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	002422	CT

General Provider Information

NPI Number	:	1285650622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON COLWELL APRN

Provider Business Mailing Address
First Line	:	999 ORONOQUE LN
Second Line	:	2ND FLOOR NORTH
City	:	STRATFORD
State	:	CT
Zip	:	06614-1379
Country	:	US
Telephone Number	:	203-212-3585
Fax Number	:

Provider Business Practice Location Address
First Line	:	999 ORONOQUE LN
Second Line	:	2ND FLOOR, NORTH
City	:	STRATFORD
State	:	CT
Zip	:	06614-1379
Country	:	US
Telephone Number	:	203-212-3585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	09/02/2014

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