Provider Demographics
NPI:1043596646
Name:FEARON, MAUREEN ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:FEARON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 NORTHWESTERN DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3463
Mailing Address - Country:US
Mailing Address - Phone:860-443-4455
Mailing Address - Fax:860-286-8411
Practice Address - Street 1:6 NORTHWESTERN DR
Practice Address - Street 2:SUITE 303
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3463
Practice Address - Country:US
Practice Address - Phone:860-443-4455
Practice Address - Fax:860-286-8411
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT004779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily