Healthcare Provider Details

I. General information

NPI: 1205790235
Provider Name (Legal Business Name): MICHELLE ANGRAND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 WHITNEY AVE
HAMDEN CT
06518-3539
US

IV. Provider business mailing address

120 WOOSTER ST
NEW HAVEN CT
06511-5722
US

V. Phone/Fax

Practice location:
  • Phone: 203-248-8142
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number15984
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number15984
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15984
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: