=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366503260
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROL A CAPLAN APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2006
-----------------------------------------------------
Last Update Date | 03/06/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 71 HAYNES ST
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06040-4131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-533-3434
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 RAILROAD AVE
-----------------------------------------------------
City | EAST HAMPTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06424-1218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-267-6351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 002520
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------