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General NPI Number Information
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NPI Number | 1992584502
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Entity Type | Individual
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Provider Name | EVADNE CLAUDIA VASCIANNA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 400 W MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-3416
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Country | US
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Telephone | 203-483-7778
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Fax |
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Provider Business Mailing Address
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Address Line | 4046 WILDER AVE FL 2
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City | BRONX
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State | NY
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Zip | 10466-2329
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Country | US
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Telephone | 307-677-1093
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 012358
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 012358
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 353027
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License Number State | NY
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