Healthcare Provider Details

I. General information

NPI: 1093313348
Provider Name (Legal Business Name): WONDER VANESSA BARRATT RN, BSN, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 GLEN HILL RD
DANBURY CT
06811-4985
US

IV. Provider business mailing address

137 WOODLAWN TER
WATERBURY CT
06710-1930
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-0506
  • Fax:
Mailing address:
  • Phone: 203-971-7188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number74930
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: