Healthcare Provider Details

I. General information

NPI: 1598549735
Provider Name (Legal Business Name): KIERSTEN D BINKOWSKI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 W MAIN ST
AVON CT
06001-4357
US

IV. Provider business mailing address

385 W MAIN ST
AVON CT
06001-4357
US

V. Phone/Fax

Practice location:
  • Phone: 860-777-1280
  • Fax:
Mailing address:
  • Phone: 860-777-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12245
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: