Provider Demographics
NPI:1235606443
Name:GARCIA, LINA M (AGPCNP-C)
Entity Type:Individual
Prefix:MS
First Name:LINA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:LINA
Other - Middle Name:M
Other - Last Name:GARCIA PINZON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:320 WESTERN BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1276
Mailing Address - Country:US
Mailing Address - Phone:860-657-5940
Mailing Address - Fax:860-633-1793
Practice Address - Street 1:320 WESTERN BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1276
Practice Address - Country:US
Practice Address - Phone:860-657-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.007909363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty