Healthcare Provider Details

I. General information

NPI: 1245906890
Provider Name (Legal Business Name): ROWAN MARGUERITE O'CONNELL-BARGER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 08/23/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 COLUMBUS AVENUE WOMEN'S HEALTH DEPARTMENT
NEW HAVEN CT
06519
US

IV. Provider business mailing address

428 COLUMBUS AVENUE WOMEN'S HEALTH DEPARTMENT
NEW HAVEN CT
06519
US

V. Phone/Fax

Practice location:
  • Phone: 203-503-3094
  • Fax:
Mailing address:
  • Phone: 203-503-3094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number9874
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: