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General NPI Number Information
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NPI Number | 1891199980
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Entity Type | Individual
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Provider Name | ELISABETH HENVY ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/19/2014
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Provider Practice Location Address
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Address Line | 226 MILL HILL AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06610-2826
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Country | US
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Telephone | 203-384-3388
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Fax | 203-384-4034
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Provider Business Mailing Address
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Address Line | 23 ELIZABETH ST
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City | BETHEL
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State | CT
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Zip | 06801-2109
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Country | US
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Telephone | 203-948-5634
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 005876
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License Number State | CT
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