MEDICARE: DR. AMELIA YVONNE GARRISON DNP, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0042191	OH
2	363LF0000X	Family Nurse Practitioner	12231	CT
3	363LF0000X	Family Nurse Practitioner	4704448493	MI

General Provider Information

NPI Number	:	1295416105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMELIA YVONNE GARRISON DNP, FNP-C

Provider Business Mailing Address
First Line	:	330 WASHINGTON ST STE 510
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2733
Country	:	US
Telephone Number	:	860-885-1308
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 WASHINGTON ST STE 510
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2745
Country	:	US
Telephone Number	:	860-885-1308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2023
Last Update Date	:	05/21/2026

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