STEPHANIE PETTINGLE APRN NPI 1205258605

NPI Information

NPI: 1205258605
Provider Name: STEPHANIE PETTINGLE, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: NORTHEAST MEDICAL GROUP INC

PECOS Registration: Yes

Address:
110 COMMERCE DR
SHELTON, CT
ZIP 06484
Phone: (203) 929-7331
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Stephanie Pettingle, APRN is a family nurse practitioner in Shelton, CT with 11 years of experience. Stephanie Pettingle, APRN NPI is 1205258605. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

110 COMMERCE DR
SHELTON, CT
ZIP 06484-244
Phone: (203) 929-7331
Fax: (203) 925-0330

The NPI 1205258605 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/20/2014 and was last updated on 5/17/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	F338355	NEW YORK	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	005676	CONNECTICUT	No
3	363LF0000X	Nurse Practitioner	Family	5676	CONNECTICUT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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