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General NPI Number Information
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NPI Number | 1114207289
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Entity Type | Organization
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Legal Business Name | KATHLEEN CARIUS, APRN
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 1129 ESSEX PL
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City | STRATFORD
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State | CT
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Zip | 06615-5867
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Country | US
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Telephone | 203-375-8050
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Fax |
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Provider Business Mailing Address
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Address Line | 1129 ESSEX PL
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City | STRATFORD
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State | CT
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Zip | 06615-5867
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Country | US
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Telephone | 203-375-8050
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTIONER
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Name | KATHLEEN CARIUS
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Credential | APRN
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Telephone | 203-375-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 003880
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License Number State | CT
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