Healthcare Provider Details

I. General information

NPI: 1780245977
Provider Name (Legal Business Name): CAITLYN A SLATER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN A COURTEMANCHE APRN

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MUNSON ROAD
FARMINGTON CT
06032-2012
US

IV. Provider business mailing address

5 MUNSON RD FL 2
FARMINGTON CT
06032-2094
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-4888
  • Fax: 860-679-0131
Mailing address:
  • Phone: 860-679-4888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number008363
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: