Healthcare Provider Details

I. General information

NPI: 1528866050
Provider Name (Legal Business Name): CNP PRIMARY CARE AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1266 E MAIN ST STE 700R
STAMFORD CT
06902-3507
US

IV. Provider business mailing address

1266 E MAIN ST STE 700R
STAMFORD CT
06902-3507
US

V. Phone/Fax

Practice location:
  • Phone: 203-340-0911
  • Fax:
Mailing address:
  • Phone: 203-340-0911
  • Fax: 203-293-7359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSE NICOLE CASIMIR
Title or Position: OWNER
Credential: FNP-C
Phone: 203-621-8208