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General NPI Number Information
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NPI Number | 1104341908
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Entity Type | Individual
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Provider Name | BRITTANY PROVENZANO RN, NP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 795 BRIDGEPORT AVE SUITE A
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City | SHELTON
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State | CT
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Zip | 06484
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Country | US
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Telephone | 860-650-3848
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Fax |
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Provider Business Mailing Address
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Address Line | 6 WILLIAMSBURG DR
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City | MONROE
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State | CT
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Zip | 06468-2507
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Country | US
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Telephone | 203-650-3168
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2342809
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License Number State | MA
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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 | 348683
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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 | 7356
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License Number State | CT
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