Nichole Brown, DNP
Individual provider Active NPI Adult Health Nurse Practitioner · North Haven, CT
NPI 1720634660 · NPPES record last updated Aug 15, 2019
Key facts
- NPI
- 1720634660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 12.008189 (CT)
- Practice address
- 360 Universal Dr N
North Haven, CT 06473 - Phone
- (800) 223-4567
- NPI assigned
- Aug 15, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 12.008189 | CT | MD | Adult Health Nurse Practitioner |
Interoperability endpoints
- nichole.brown@idealimage.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 12.008189 | CT | Yes |
Addresses
Primary practice location
360 Universal Dr N
North Haven, CT 06473
Mailing address
360 Universal Dr N
North Haven, CT 06473-3163
Phone (800) 234-3325
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Nichole.brown@idealimage.com |
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- Jeremiah Brown
- Sabrina L. Browning
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All providers in North Haven, CT · Adult Health Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2019. 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.