Healthcare Provider Details

I. General information

NPI: 1104086362
Provider Name (Legal Business Name): FRANCES M. DEEGAN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 JAFFEE TER
COLCHESTER CT
06415-1004
US

IV. Provider business mailing address

59 HARRINGTON CT
COLCHESTER CT
06415-1207
US

V. Phone/Fax

Practice location:
  • Phone: 860-537-1465
  • Fax: 860-537-1465
Mailing address:
  • Phone: 860-537-2339
  • Fax: 860-537-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number375031-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number004260
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: