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General NPI Number Information
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NPI Number | 1033610241
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Entity Type | Organization
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Legal Business Name | ELIZABETH ALVE-HEDEGAARD APRN LLC
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 10 N MAIN ST STE 204
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1941
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Country | US
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Telephone | 203-409-8655
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Fax |
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Provider Business Mailing Address
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Address Line | 32 BRIAN RD
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City | WEST HARTFORD
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State | CT
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Zip | 06110-2509
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ELIZABETH ALVE-HEDEGAARD
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Credential | APRN
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Telephone | 203-843-6940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 006104
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License Number State | CT
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