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NPI Code Detail

MEDICARE: MICHAEL ESPELIN APRN LLC

MEDICARE: MICHAEL ESPELIN APRN LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1912541210
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL ESPELIN APRN LLC
Provider Business Mailing Address
First Line : 1204 MAIN ST STE 575
Second Line :
City : BRANFORD
State : CT
Zip : 06405-3787
Country : US
Telephone Number : 347-762-5352
Fax Number : 928-272-0190
Provider Business Practice Location Address
First Line : 145 DURHAM RD STE 6
Second Line :
City : MADISON
State : CT
Zip : 06443-2656
Country : US
Telephone Number : 347-762-5352
Fax Number : 928-272-0190
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MICHAEL ESPELIN
Credential : APRN, PMHNP
Telephone Number : 347-762-5352
Provider Enumeration Date : 10/30/2019
Last Update Date : 04/20/2022

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