Healthcare Provider Details

I. General information

NPI: 1124817432
Provider Name (Legal Business Name): MONICA ERWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
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

64 E RIDGE DR
MIDDLEBURY CT
06762-2025
US

V. Phone/Fax

Practice location:
  • Phone: 860-736-5386
  • Fax:
Mailing address:
  • Phone: 203-695-8212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14770
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: