Healthcare Provider Details

I. General information

NPI: 1043044316
Provider Name (Legal Business Name): BRENNA DION APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 STATE ST
MERIDEN CT
06450-3293
US

IV. Provider business mailing address

19 GRAND ST
MIDDLETOWN CT
06457-2705
US

V. Phone/Fax

Practice location:
  • Phone: 203-237-2229
  • Fax: 203-686-1677
Mailing address:
  • Phone: 860-347-6971
  • Fax: 860-343-7379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13766
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: