Healthcare Provider Details

I. General information

NPI: 1255972964
Provider Name (Legal Business Name): GEETA SHARMA DNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 N MAIN ST
BRANFORD CT
06405-3034
US

IV. Provider business mailing address

85 N MAIN ST
BRANFORD CT
06405-3034
US

V. Phone/Fax

Practice location:
  • Phone: 203-689-0558
  • Fax:
Mailing address:
  • Phone: 32-689-0558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number8503
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: