Gweneth M Douglas, APRN
Nurse Practitioner, Psych/Mental Health in Hartford, CT. Individual provider (NPI-1).
NPI number1083172811
StatusActive
Last updated in NPPESJun 30, 2020
Details
- NPI
- 1083172811
- Entity type
- Individual (NPI-1)
- Name
- Ms. Gweneth M Douglas
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 11, 2019
- Certification date
- Jun 30, 2020
- Last updated
- Jun 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 7942 | CT | Yes |
| 163WP0808X | Registered Nurse, Psych/Mental Health | 7942 | CT |
Practice location
675 Tower Ave Ste 301Hartford, CT 06112-1274
Phone 860-714-8275 · Fax 860-714-8591
Mailing address
675 Tower Ave Ste 301Hartford, CT 06112-1274
Phone 860-714-8275 · Fax 860-714-8591
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