Healthcare Provider Details

I. General information

NPI: 1093737249
Provider Name (Legal Business Name): HEATHER CHRISTINE GATESMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER CHRISTINE SMARZ APRN

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BERKSHIRE RD
SANDY HOOK CT
06482-1361
US

IV. Provider business mailing address

15 BERKSHIRE RD
SANDY HOOK CT
06482-1361
US

V. Phone/Fax

Practice location:
  • Phone: 203-270-4335
  • Fax: 203-270-4338
Mailing address:
  • Phone: 203-270-4335
  • Fax: 203-270-4338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003467
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number003467
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: