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General NPI Number Information
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NPI Number | 1194538330
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Entity Type | Organization
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Legal Business Name | RISE WELLNESS LLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 89 CT RT 39 SUITE 8
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City | NEW FAIRFIELD
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State | CT
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Zip | 06812
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Country | US
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Telephone | 860-237-5511
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 511
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City | SHERMAN
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State | CT
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Zip | 06784-0511
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Country | US
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Telephone | 860-539-1251
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | CAITLIN DOODY
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Credential | FNP-BC
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Telephone | 860-237-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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