Provider Demographics
NPI:1124036983
Name:DEPINO, LINDA JEAN (MS APRN CRNA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JEAN
Last Name:DEPINO
Suffix:
Gender:F
Credentials:MS APRN CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3475
Mailing Address - Country:US
Mailing Address - Phone:203-467-4264
Mailing Address - Fax:
Practice Address - Street 1:1423 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-865-3852
Practice Address - Fax:203-865-2983
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002678367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered