Healthcare Provider Details

I. General information

NPI: 1790238020
Provider Name (Legal Business Name): COLLEEN TAYLOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 WHITNEY AVE
NEW HAVEN CT
06511-2348
US

IV. Provider business mailing address

21 GRAND ST
HARTFORD CT
06106-1541
US

V. Phone/Fax

Practice location:
  • Phone: 203-503-0450
  • Fax:
Mailing address:
  • Phone: 860-550-7500
  • Fax: 860-550-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN04045
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number6595
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: