Healthcare Provider Details

I. General information

NPI: 1003972878
Provider Name (Legal Business Name): PAULA M. MCCAULEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCONN MEDICAL GROUP 263 FARMINGTON AVE
FARMINGTON CT
06030-0001
US

IV. Provider business mailing address

UCONN MEDICAL GROUP 263 FARMINGTON AVE
FARMINGTON CT
06030-0001
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-6600
  • Fax: 860-679-6649
Mailing address:
  • Phone: 860-679-6600
  • Fax: 860-679-6649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number001988
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: