Healthcare Provider Details

I. General information

NPI: 1962608927
Provider Name (Legal Business Name): CYNTHIA LAURA KIRKLAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 OLD ROUTE 7
BROOKFIELD CT
06804-1711
US

IV. Provider business mailing address

31 OLD ROUTE 7
BROOKFIELD CT
06804-1711
US

V. Phone/Fax

Practice location:
  • Phone: 475-253-2599
  • Fax:
Mailing address:
  • Phone: 475-253-2599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP115910
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2378219
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351509
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8417
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: