Healthcare Provider Details

I. General information

NPI: 1376253484
Provider Name (Legal Business Name): LAUREN STEELE RN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 BURNSIDE AVE
EAST HARTFORD CT
06108-2425
US

IV. Provider business mailing address

478 BURNSIDE AVE
EAST HARTFORD CT
06108-2425
US

V. Phone/Fax

Practice location:
  • Phone: 860-528-1359
  • Fax:
Mailing address:
  • Phone: 860-528-1359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number266247
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number12290
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: