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General NPI Number Information
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NPI Number | 1457724056
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Entity Type | Organization
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Legal Business Name | FAIRFIELD HEALTH AND WELLNESS SOLUTIONS, LLC
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 324 ELM ST SUITE 203A
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City | MONROE
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State | CT
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Zip | 06468-2280
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Country | US
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Telephone | 203-220-6306
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Fax | 203-220-6308
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Provider Business Mailing Address
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Address Line | 324 ELM ST SUITE 203A
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City | MONROE
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State | CT
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Zip | 06468-2280
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Country | US
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Telephone | 203-220-6306
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Fax | 203-220-6308
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. DEENNA MONICA NEALON
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Credential | APRN
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Telephone | 203-220-6306
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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 | 001767
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License Number State | CT
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