Provider Demographics
NPI:1326048281
Name:LAMOUR, GISELA (APRN)
Entity Type:Individual
Prefix:
First Name:GISELA
Middle Name:
Last Name:LAMOUR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CORPORATE DR STE 295
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6240
Mailing Address - Country:US
Mailing Address - Phone:203-374-6103
Mailing Address - Fax:203-374-1663
Practice Address - Street 1:4 CORPORATE DR STE 295
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6240
Practice Address - Country:US
Practice Address - Phone:203-374-6103
Practice Address - Fax:203-374-1663
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002682363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP73858Medicare UPIN