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General NPI Number Information
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NPI Number | 1801377502
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Entity Type | Individual
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Provider Name | DANA O'SULLIVAN APRN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 282 MAIN STREET EXT STE A3
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4467
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Country | US
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Telephone | 860-270-0506
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 481
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City | VERNON
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State | CT
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Zip | 06066-0481
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Country | US
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Telephone | 860-753-1939
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 7772
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License Number State | CT
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