Individual provider Active NPI

Nancy Deirdra Munnelly, RN

  • Critical Care Medicine Registered Nurse
  • Weston, CT
National Provider Identifier
1578054664
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
288644 Issued in NY
Practice address
4 Whippoorwill LN
Weston, CT 06883-1010
Phone
(203) 544-1058
NPI assigned
May 23, 2018
Last updated
May 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 288644 NY Primary

Addresses

Primary practice location

4 Whippoorwill LN
Weston, CT 06883-1010

Mailing address

4 Whippoorwill LN
Weston, CT 06883-1010
Phone (203) 544-1058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1578054664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WHIPPOORWILL LN",
            "city": "WESTON",
            "state": "CT",
            "postal_code": "068831010",
            "telephone_number": "203-544-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WHIPPOORWILL LN",
            "city": "WESTON",
            "state": "CT",
            "postal_code": "068831010",
            "telephone_number": "203-544-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNNELLY",
        "first_name": "NANCY",
        "middle_name": "DEIRDRA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "288644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.