Healthcare Provider Details

I. General information

NPI: 1316322696
Provider Name (Legal Business Name): RACHEL HEGGLAND APRN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL M BRYAN

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CAMBRIDGE DR STE 201
TRUMBULL CT
06611-4763
US

IV. Provider business mailing address

7 CAMBRIDGE DR STE 201
TRUMBULL CT
06611-4763
US

V. Phone/Fax

Practice location:
  • Phone: 203-335-0195
  • Fax: 203-335-7293
Mailing address:
  • Phone: 203-335-0195
  • Fax: 203-335-7293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6171
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: