Healthcare Provider Details

I. General information

NPI: 1588429823
Provider Name (Legal Business Name): DANIELLE MARY URSONE DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 MAIN ST STE 219
BRIDGEPORT CT
06606-5301
US

IV. Provider business mailing address

2660 MAIN ST STE 219
BRIDGEPORT CT
06606-5301
US

V. Phone/Fax

Practice location:
  • Phone: 203-505-4630
  • Fax:
Mailing address:
  • Phone: 203-505-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number015202
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: