Healthcare Provider Details

I. General information

NPI: 1851450159
Provider Name (Legal Business Name): DENISE EVETTE MOZONE MARSHALL DNP,APRN,CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 NEW BRITAIN AVE
HARTFORD CT
06106-3305
US

IV. Provider business mailing address

1236 CLAIRE ST
LANTANA TX
76226-5537
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9300
  • Fax:
Mailing address:
  • Phone: 972-302-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP5053
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP113086
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number113086
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number13966
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: