Healthcare Provider Details

I. General information

NPI: 1386892321
Provider Name (Legal Business Name): NANCY J DALRYMPLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 LAFAYETTE STREET
NEW BRITAIN CT
06051
US

IV. Provider business mailing address

17 LACEY RD
SOUTHINGTON CT
06489-3711
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-3642
  • Fax: 860-224-2760
Mailing address:
  • Phone: 206-579-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number097354
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN00174711
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number004572
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: