TANYA THERIAULT APRN NPI 1851647820

NPI Information

NPI: 1851647820
Provider Name: TANYA THERIAULT, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
85 LAFAYETTE STREET
NEW BRITAIN, CT
ZIP 06052
Phone: (860) 224-3642
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Tanya Theriault, APRN is a family nurse practitioner in New Britain, CT with 12 years of experience. Tanya Theriault, APRN NPI is 1851647820. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: YALE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2012

The provider's business location address is:

85 LAFAYETTE STREET
NEW BRITAIN, CT
ZIP 06052
Phone: (860) 224-3642

The NPI 1851647820 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 7/27/2012 and was last updated on 10/22/2012.

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	163W00000X	Registered Nurse		98997	CONNECTICUT	No
2	363LF0000X	Nurse Practitioner	Family	005103	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004236346	MEDICAID	CONNECTICUT

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: 4/28/2024

NPI Synchronization or Removal

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