MEDICARE: MRS. KERRY J SPERRAZZA-GABOW APRN-CNP

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	363LF0000X	Family Nurse Practitioner	10620	CT

General Provider Information

NPI Number	:	1700694007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KERRY J SPERRAZZA-GABOW APRN-CNP

Provider Business Mailing Address
First Line	:	20 BARKSDALE RD
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06117-1603
Country	:	US
Telephone Number	:	860-992-8287
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 BARKSDALE RD
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06117-1603
Country	:	US
Telephone Number	:	--
Fax Number	:

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

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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