MARY SCHULTZ FORMAN APRN NPI 1164868030

NPI Information

NPI: 1164868030
Provider Name: MARY SCHULTZ FORMAN, APRN
Classification: Clinical Nurse Specialist - 364SP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
415 MAIN ST
WEST HAVEN, CT
ZIP 06516
Phone: (203) 931-1184
Get Directions

Mary Schultz Forman, APRN is a psychiatric/mental health clinical nurse specialist in West Haven, CT. Mary Schultz Forman, APRN NPI is 1164868030. 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:

415 MAIN ST
WEST HAVEN, CT
ZIP 06516-296
Phone: (203) 931-1184
Fax: (203) 931-0063

The enumeration date for this NPI number is 5/17/2013 and was last updated on 5/17/2013.

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	364SP0808X	Clinical Nurse Specialist	Psychiatric/Mental Health	004082	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: 5/5/2024

NPI Synchronization or Removal

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