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NPI Code Detail

MEDICARE: MINDING YOUR HEALTH, LLC

MEDICARE: MINDING YOUR HEALTH, LLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1841763901
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDING YOUR HEALTH, LLC
Provider Business Mailing Address
First Line : 560 MICHELLE LN
Second Line :
City : THOMASTON
State : CT
Zip : 06787-1289
Country : US
Telephone Number : 860-880-8111
Fax Number :
Provider Business Practice Location Address
First Line : 457 BANTAM RD STE 9
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-3225
Country : US
Telephone Number : 860-262-3747
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JENNIFER A NOLAN
Credential : APRN
Telephone Number : 860-880-8111
Provider Enumeration Date : 01/10/2019
Last Update Date : 01/10/2019

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Directions to “MINDING YOUR HEALTH, LLC ” Practice Location

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