Healthcare Provider Details

I. General information

NPI: 1679764211
Provider Name (Legal Business Name): SHELDON LEONARD HOLLINS APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 MAIN ST
EAST HARTFORD CT
06108-2236
US

IV. Provider business mailing address

1137 MAIN ST STE 102
EAST HARTFORD CT
06108-2236
US

V. Phone/Fax

Practice location:
  • Phone: 860-849-9804
  • Fax: 860-854-2917
Mailing address:
  • Phone: 860-849-9804
  • Fax: 860-854-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number270356
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: