Provider Demographics
NPI:1114924172
Name:VISONE, ELIZABETH MB (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MB
Last Name:VISONE
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1060 DAY HILL RD STE 203
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-5720
Practice Address - Country:US
Practice Address - Phone:860-696-2450
Practice Address - Fax:860-696-2460
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002572363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT31440OtherST CONTROLLED SUBSTANCE #
CT002572OtherSTATE APRN LICENSE
CTE43356OtherSTATE RN LICENSE NUMBER
CTE43356OtherSTATE RN LICENSE NUMBER