Healthcare Provider Details

I. General information

NPI: 1053833475
Provider Name (Legal Business Name): MONA ANNE CHIURILLO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 S MAIN ST
PLANTSVILLE CT
06479-1645
US

IV. Provider business mailing address

26 MEADOW RD
CROMWELL CT
06416-2475
US

V. Phone/Fax

Practice location:
  • Phone: 860-736-5386
  • Fax: 860-263-8291
Mailing address:
  • Phone: 860-970-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number12.007065
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.007065
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: