Healthcare Provider Details

I. General information

NPI: 1447314695
Provider Name (Legal Business Name): MARTHA MINIHAN MITCHELL RNC MS CAPT NC USNR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA MINIHAN

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 HOWARD AVENUE YALE NEW HAVEN HOSPITAL WOMENS CENTER
NEW HAVEN CT
06519
US

IV. Provider business mailing address

25 MAIN STREET
STONINGTON CT
06378-1450
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-4101
  • Fax: 203-688-1101
Mailing address:
  • Phone: 860-535-3078
  • Fax: 860-535-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number002646
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF4205041
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number96313
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: