Healthcare Provider Details

I. General information

NPI: 1023710050
Provider Name (Legal Business Name): DANA MULLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 FARMINGTON AVE APT 302
WEST HARTFORD CT
06119-1507
US

IV. Provider business mailing address

810 FARMINGTON AVE APT 302
WEST HARTFORD CT
06119-1507
US

V. Phone/Fax

Practice location:
  • Phone: 860-573-7211
  • Fax:
Mailing address:
  • Phone: 860-573-7211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number113328
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: