Healthcare Provider Details

I. General information

NPI: 1043100332
Provider Name (Legal Business Name): MADELINE HOWARD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 S MAIN ST STE 312
WEST HARTFORD CT
06107-2403
US

IV. Provider business mailing address

30 JORDAN LANE
WETHERSFIELD CT
06109-1278
US

V. Phone/Fax

Practice location:
  • Phone: 860-247-2530
  • Fax: 860-524-7727
Mailing address:
  • Phone: 860-845-0905
  • Fax: 860-913-2587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number15363
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: