Healthcare Provider Details

I. General information

NPI: 1437654225
Provider Name (Legal Business Name): ANNMARIE BERNIER, APRN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 S MAIN ST STE 307
WEST HARTFORD CT
06107-2402
US

IV. Provider business mailing address

45 S MAIN ST STE 307
WEST HARTFORD CT
06107-2402
US

V. Phone/Fax

Practice location:
  • Phone: 860-480-0198
  • Fax: 860-236-1909
Mailing address:
  • Phone: 860-480-0198
  • Fax: 860-236-1909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number003828
License Number StateCT

VIII. Authorized Official

Name: MS. ANNMARIE BERNIER
Title or Position: APRN
Credential: APRN
Phone: 860-480-0198