MS. GWENETH M DOUGLAS (NPI# 1083172811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083172811 |
| Entity Type | Individual |
| Full Name | MS. GWENETH M DOUGLAS |
| Credential | APRN |
| Practice Address |
675 Tower Ave Ste 301 Hartford CT 06112-1274 |
| Practice Telephone | 8607148275 |
| Practice Fax Number | 8607148591 |
| Mailing Telephone | 8607148275 |
| Mailing Fax Number | 8607148591 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2020-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
7942 | CT | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
7942 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
675 TOWER AVE STE 301 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164515946 | Jane Romano | Nurse Practitioner | 675 Tower Ave Ste 301, Hartford, CT 06112-1260 | 2006-10-02 |
| 1386066470 | Amber Irimia | Nurse Practitioner | 675 Tower Ave Ste 301, Hartford, CT 06112 | 2014-01-09 |
| 1407298151 | Nayla Hariz | Psychiatry & Neurology | 675 Tower Ave Ste 301, Hartford, CT 06112 | 2013-07-23 |
| 1265647713 | Larisa Yelunina | Psychiatry & Neurology | 675 Tower Ave Ste 301, Hartford, CT 06112-1274 | 2007-05-10 |
| 1255424057 | Orlando Marichal | Social Worker | 675 Tower Ave Ste 301, Hartford, CT 06112-1260 | 2006-10-02 |
| 1316030117 | Jennifer Mowry | Social Worker | 675 Tower Ave Ste 301, Hartford, CT 06112-1260 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649888256 | Healthy Minds Pllc | Nurse Practitioner | 40 Russ St, Hartford, CT 06106-1520 | 2020-07-20 |
| 1164515946 | Jane Romano | Nurse Practitioner | 675 Tower Ave Ste 301, Hartford, CT 06112-1260 | 2006-10-02 |
| 1427661420 | Advanced Clinical Services LLC | Nurse Practitioner | 556 Zion St, Hartford, CT 06106-2348 | 2020-08-28 |
| 1891316113 | Taryn Westfall | Nurse Practitioner | 330 Main St, Hartford, CT 06106-1860 | 2020-04-27 |
| 1295374668 | Jess Adelman, Aprn LLC | Nurse Practitioner | 51 Gillett St, Hartford, CT 06105-2636 | 2020-01-02 |
| 1982243580 | Melissa Richardson | Nurse Practitioner | 21 Grand St, Hartford, CT 06106-1541 | 2019-12-30 |
| 1710537063 | Chengping Wang | Nurse Practitioner | 500 Albany Ave, Hartford, CT 06120-2508 | 2019-09-18 |
| 1538726930 | Denielle M Mccarthy | Nurse Practitioner | 200 Retreat Ave, Hartford Hospital Psych Dept, Hartford, CT 06106-3309 | 2019-05-22 |
| 1083199764 | Kemmarie Beal, Np, LLC | Nurse Practitioner | 3580 Main St, Hartford, CT 06120-1121 | 2018-09-28 |
| 1497233803 | Emily D Farb | Nurse Practitioner | 200 Retreat Ave, Hartford Hospital Psych Dept, Hartford, CT 06106-3309 | 2018-07-30 |
| Find all providers in HARTFORD | ||||
Please comment or provide details below to improve the information on MS. GWENETH M DOUGLAS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.