Healthcare Provider Details

I. General information

NPI: 1285310730
Provider Name (Legal Business Name): VICTORIA FOOTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 OLD PARK LANE RD
NEW MILFORD CT
06776-2507
US

IV. Provider business mailing address

11 OLD PARK LANE RD
NEW MILFORD CT
06776-2507
US

V. Phone/Fax

Practice location:
  • Phone: 860-355-1149
  • Fax: 860-210-2008
Mailing address:
  • Phone: 860-355-1149
  • Fax: 860-210-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12174
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number152036
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: