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General NPI Number Information
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NPI Number | 1992940365
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Entity Type | Individual
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Provider Name | ANNE KONERU
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Gender | Female
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 417 LIBERTY ST STE 2
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City | SPRINGFIELD
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State | MA
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Zip | 01104-3766
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Country | US
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Telephone | 413-301-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 701 COTTAGE GROVE RD STE B110
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City | BLOOMFIELD
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State | CT
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Zip | 06002-4217
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Country | US
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Telephone | 203-637-5882
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Fax | 855-524-3980
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3957
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2259886
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License Number State | MA
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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 | RN2259886
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 003957
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License Number State | CT
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