Provider Demographics
NPI:1659080075
Name:FRENCH, MIKAL DANFORTH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MIKAL
Middle Name:DANFORTH
Last Name:FRENCH
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LITTLE CITY RD
Mailing Address - Street 2:
Mailing Address - City:KILLINGWORTH
Mailing Address - State:CT
Mailing Address - Zip Code:06419-1021
Mailing Address - Country:US
Mailing Address - Phone:203-915-5139
Mailing Address - Fax:
Practice Address - Street 1:117 WESTON STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120
Practice Address - Country:US
Practice Address - Phone:959-200-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT131608163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse