Healthcare Provider Details

I. General information

NPI: 1205442027
Provider Name (Legal Business Name): LINDSEY WATKINS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

255 HEMPSTEAD ST
NEW LONDON CT
06320-6290
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9440
  • Fax: 860-545-9445
Mailing address:
  • Phone: 860-443-2896
  • Fax: 860-442-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number9136
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: