Healthcare Provider Details

I. General information

NPI: 1154320562
Provider Name (Legal Business Name): LOUANN PERUGINI NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOUANN PERUGINI FNP, ACNP, DCNP

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 BOSTON POST RD SUITE 300
MILFORD CT
06460-3537
US

IV. Provider business mailing address

PO BOX 1252
SOUTHBURY CT
06488-8252
US

V. Phone/Fax

Practice location:
  • Phone: 912-659-9614
  • Fax:
Mailing address:
  • Phone: 203-456-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR190982
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number166646
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.005229
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP011144
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP166646
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR190982
License Number StateMD
# 7
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number005229
License Number StateCT
# 8
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number5229
License Number StateCT
# 9
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberR166646
License Number StateGA
# 10
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number5220
License Number StateCT
# 11
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberSP011144
License Number StatePA
# 12
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberR166646
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: