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General NPI Number Information
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NPI Number | 1598584526
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Entity Type | Individual
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Provider Name | REBECCA IANNOTTI APRN
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 3801 E MAIN ST
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City | WATERBURY
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State | CT
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Zip | 06705-3815
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Country | US
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Telephone | 203-709-4001
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Fax | 203-709-5293
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Provider Business Mailing Address
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Address Line | 20 TRACEY ANN CT
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City | NAUGATUCK
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State | CT
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Zip | 06770-3465
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Country | US
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Telephone | 203-217-7801
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 165714
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 16503
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License Number State | CT
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