Healthcare Provider Details

I. General information

NPI: 1477026201
Provider Name (Legal Business Name): KERRYANN MCCOOTY-LAWRENCE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KERRY-ANN DALEY NP

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 ASYLUM ST
HARTFORD CT
06103-3408
US

IV. Provider business mailing address

185 ASYLUM ST
HARTFORD CT
06103-3408
US

V. Phone/Fax

Practice location:
  • Phone: 860-861-1357
  • Fax:
Mailing address:
  • Phone: 860-861-1357
  • Fax: 855-714-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11439
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number99969
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: