Kristy Victoria Davenport, REGISTERED NURSE
Individual provider Active NPI Registered Nurse · Mansfield Center, CT
NPI 1164720397 · NPPES record last updated Mar 11, 2011
Key facts
- NPI
- 1164720397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 082694 (CT)
- Practice address
- 189 Storrs Rd
Mansfield Center, CT 06250-1683 - Phone
- (203) 621-4773
- NPI assigned
- Mar 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 082694 | CT | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 082694 | CT | Yes |
Addresses
Primary practice location
189 Storrs Rd
Mansfield Center, CT 06250-1683
Mailing address
26 Boston Post Rd
# 188
Waterford, CT 06385-2402
Phone (203) 621-4773
Other providers in Mansfield Center, CT
- Marc John Czarnowski
- Kate D'Addabbo
- Fabiana Aretusa Da Silva
- Karen Ann Daly
- Danielle N. Christian, LCSW, LLC
- Olivia Davenport
- David Henry, PH.D.
- Susan Davis
- Khara Lee Dean
- Francis Anthony Degennaro III
All providers in Mansfield Center, CT · Registered Nurse in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.