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General NPI Number Information
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NPI Number | 1205869112
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Entity Type | Individual
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Provider Name | KATHARINE NICOLE VARDANIAN MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 1 ROYCE CIR STE 104
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City | STORRS
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State | CT
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Zip | 06268-2270
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Country | US
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Telephone | 860-487-9200
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Fax | 860-487-9222
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Provider Business Mailing Address
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Address Line | 1 ROYCE CIR STE 104
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City | STORRS
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State | CT
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Zip | 06268-2270
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Country | US
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Telephone | 860-487-9200
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Fax | 860-487-9222
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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 | 001111
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License Number State | CT
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