Healthcare Provider Details

I. General information

NPI: 1407231780
Provider Name (Legal Business Name): ANNA GUT APRN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 09/09/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 WHITE PLAINS RD BLDG A2
TRUMBULL CT
06611-4857
US

IV. Provider business mailing address

502 WHITE PLAINS RD
TRUMBULL CT
06611-4857
US

V. Phone/Fax

Practice location:
  • Phone: 860-810-2302
  • Fax: 203-349-2087
Mailing address:
  • Phone: 860-810-2302
  • Fax: 203-349-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number001319
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code364SP0811X
TaxonomyChronically Ill Psychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 8
Primary TaxonomyN
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 9
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT
# 10
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number001319
License Number StateCT

VIII. Authorized Official

Name: ANNA GUT
Title or Position: CNS/APRN
Credential: CNS, PMH-BC, APRN
Phone: 860-810-2302