Healthcare Provider Details

I. General information

NPI: 1376427682
Provider Name (Legal Business Name): CAROLINA ACOSTA PABON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOPE ST
BRISTOL CT
06010-6374
US

IV. Provider business mailing address

27 CONCORD ST
BRISTOL CT
06010-3609
US

V. Phone/Fax

Practice location:
  • Phone: 888-793-3500
  • Fax:
Mailing address:
  • Phone: 860-940-8253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number15101
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number15101
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15101
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: