Healthcare Provider Details

I. General information

NPI: 1891359188
Provider Name (Legal Business Name): ABIGAIL ROSE DONNELL DNP, CRNA, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL ROSE PURDY

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

IV. Provider business mailing address

99 EAST RIVER DRIVE 5TH FLOOR
EAST HARTFORD CT
06108-7301
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-5000
  • Fax:
Mailing address:
  • Phone: 860-282-0833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8288
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number132563
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: