Healthcare Provider Details

I. General information

NPI: 1447206909
Provider Name (Legal Business Name): DARLENE A KUPINSKI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARLENE A ZETTERGREN APRN

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 BART DR
COLLINSVILLE CT
06019-3045
US

IV. Provider business mailing address

79 BART DR
COLLINSVILLE CT
06019-3045
US

V. Phone/Fax

Practice location:
  • Phone: 860-951-5351
  • Fax: 860-352-2090
Mailing address:
  • Phone: 860-951-5351
  • Fax: 860-352-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number003006
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: