Provider Demographics
NPI:1447206909
Name:KUPINSKI, DARLENE A (APRN)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:A
Last Name:KUPINSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:A
Other - Last Name:ZETTERGREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:79 BART DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06019-3045
Mailing Address - Country:US
Mailing Address - Phone:860-951-5351
Mailing Address - Fax:860-352-2090
Practice Address - Street 1:79 BART DR
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3045
Practice Address - Country:US
Practice Address - Phone:860-951-5351
Practice Address - Fax:860-352-2090
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003006363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTQ02984Medicare UPIN