Healthcare Provider Details

I. General information

NPI: 1922849231
Provider Name (Legal Business Name): ALLISON MORA DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HERALD SQ
NEW BRITAIN CT
06051-5009
US

IV. Provider business mailing address

1 HERALD SQ
NEW BRITAIN CT
06051-5009
US

V. Phone/Fax

Practice location:
  • Phone: 860-827-1343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13513
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number148763
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: