Healthcare Provider Details

I. General information

NPI: 1497094866
Provider Name (Legal Business Name): AMY KELLY ROBERTS DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 WELLINGTON RD
MILFORD CT
06461-1641
US

IV. Provider business mailing address

58 WELLINGTON RD
MILFORD CT
06461-1641
US

V. Phone/Fax

Practice location:
  • Phone: 203-307-3030
  • Fax:
Mailing address:
  • Phone: 203-307-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5377
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: