Healthcare Provider Details

I. General information

NPI: 1801978242
Provider Name (Legal Business Name): CATHY A CHASSE RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHY A BELANGER RNFA

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 NUTMEG RD
BRISTOL CT
06010-2686
US

IV. Provider business mailing address

34 NUTMEG RD
BRISTOL CT
06010-2686
US

V. Phone/Fax

Practice location:
  • Phone: 860-583-8136
  • Fax:
Mailing address:
  • Phone: 860-583-8136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberE57962
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: