Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 009303 | CT |
NPI | 1003372442 |
---|---|
Provider Name | Caroline Clara Regan |
First Address | Norwalk, CT 06850-3894 |
Second Address | Norwalk, CT 06850-3894 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2019 |
Last Update Date | 07/02/2022 |