Healthcare Provider Details

I. General information

NPI: 1184747644
Provider Name (Legal Business Name): VANESSA MILNE HURTA RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 POST RD SUITE 101
FAIRFIELD CT
06824-5730
US

IV. Provider business mailing address

2000 POST RD SUITE 101
FAIRFIELD CT
06824-5730
US

V. Phone/Fax

Practice location:
  • Phone: 203-418-9520
  • Fax:
Mailing address:
  • Phone: 203-418-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number335131
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5665
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: