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General NPI Number Information
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NPI Number | 1003204652
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Entity Type | Individual
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Provider Name | GRACE MARIE CARVER SANFILIPPO
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Gender | Female
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Dates
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Enumeration Date | 01/06/2015
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 17 CASE ST
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City | NORWICH
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State | CT
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Zip | 06360-2208
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Country | US
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Telephone | 860-886-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 17 CASE ST
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City | NORWICH
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State | CT
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Zip | 06360-2208
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Country | US
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Telephone | 860-886-2461
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 692706
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340312
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2321628
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7322
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License Number State | CT
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