Healthcare Provider Details

I. General information

NPI: 1295416105
Provider Name (Legal Business Name): AMELIA YVONNE GARRISON DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 WASHINGTON ST STE 510
NORWICH CT
06360-2745
US

IV. Provider business mailing address

330 WASHINGTON ST STE 510
NORWICH CT
06360-2733
US

V. Phone/Fax

Practice location:
  • Phone: 860-885-1308
  • Fax:
Mailing address:
  • Phone: 860-885-1308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042191
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12231
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704448493
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: