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General NPI Number Information
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NPI Number | 1679285027
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Entity Type | Organization
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Legal Business Name | PRACTITIONERS ADVANCING HEALTHCARE
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Dates
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Enumeration Date | 12/16/2022
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 1245 FARMINGTON AVE STE 1288
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2667
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Country | US
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Telephone | 860-833-2107
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 FARMINGTON AVE STE 1288
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2667
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Country | US
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Telephone | 860-833-9207
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | COLLEEN STODDART
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Credential | APRN
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Telephone | 860-833-9207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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