Healthcare Provider Details

I. General information

NPI: 1013889351
Provider Name (Legal Business Name): OLIVIA FRANCES GODFREY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA FRANCES BARIL FNP-C

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LONG WHARF DR STE 105
NEW HAVEN CT
06511-5944
US

IV. Provider business mailing address

1 LONG WHARF DR STE 105
NEW HAVEN CT
06511-5944
US

V. Phone/Fax

Practice location:
  • Phone: 203-865-3737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.015370
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: