Healthcare Provider Details

I. General information

NPI: 1598763807
Provider Name (Legal Business Name): KAREN VEITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MAIN ST
MIDDLETOWN CT
06457-2718
US

IV. Provider business mailing address

635 MAIN ST ATTN: CREDENTIALING DEPARTMENT
MIDDLETOWN CT
06457-2718
US

V. Phone/Fax

Practice location:
  • Phone: 860-347-6971
  • Fax: 860-343-7379
Mailing address:
  • Phone: 860-347-6971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number002461
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: