Maranda Gourley, MPH, MSN, PNP-PC
Nurse Practitioner, Pediatrics in New Haven, CT. Individual provider (NPI-1).
NPI number1730713512
StatusActive
Last updated in NPPESFeb 9, 2021
Details
- NPI
- 1730713512
- Entity type
- Individual (NPI-1)
- Name
- Maranda Gourley
- Credential
- MPH, MSN, PNP-PC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2020
- Certification date
- Feb 9, 2021
- Last updated
- Feb 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 9041 | CT | Yes |
| 163WG0000X | Registered Nurse, General Practice | 153396 | CT |
Other names
- Maranda Hyde (Former Name)
Practice location
50 Grand AveNew Haven, CT 06513-3949
Phone 203-777-7411
Mailing address
226 Bishop St Fl 3New Haven, CT 06511-3718
Phone 507-450-8262
Other practice locations
55 Lock St
New Haven, CT 06511-3603
New Haven, CT 06511-3603
Phone 203-432-0206
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