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General NPI Number Information
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NPI Number | 1487106316
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Entity Type | Individual
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Provider Name | CAITLIN O HARRIS APRN
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Gender | Female
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 112 QUARRY ROAD SUITE 120
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City | TRUMBULL
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State | CT
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Zip | 06611-4816
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Country | US
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Telephone | 203-372-4065
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Fax | 203-372-1644
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Provider Business Mailing Address
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Address Line | 112 QUARRY ROAD SUITE 120
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City | TRUMBULL
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State | CT
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Zip | 06611-4816
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Country | US
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Telephone | 203-372-4065
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Fax | 203-372-1644
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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 | 006697
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License Number State | CT
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