Healthcare Provider Details

I. General information

NPI: 1275767220
Provider Name (Legal Business Name): DANIELLE MORGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 STATE ST
NEW HAVEN CT
06511-3924
US

IV. Provider business mailing address

PO BOX 3589
MILFORD CT
06460-0945
US

V. Phone/Fax

Practice location:
  • Phone: 203-772-1077
  • Fax:
Mailing address:
  • Phone: 203-772-1077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number002343
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number002343
License Number StateCT

VIII. Authorized Official

Name: MS. DANIELLE ROSEMARY MORGAN
Title or Position: GENERAL MANAGER
Credential: APRN
Phone: 203-772-1077