Healthcare Provider Details

I. General information

NPI: 1659397271
Provider Name (Legal Business Name): NOEL WERLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 GLEN RD 4TH FLOOR
SANDY HOOK CT
06482-1193
US

IV. Provider business mailing address

393 CENTRAL AVE
NEW HAVEN CT
06515-2207
US

V. Phone/Fax

Practice location:
  • Phone: 203-304-9502
  • Fax:
Mailing address:
  • Phone: 203-387-2085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number001846
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: