Provider Demographics
NPI:1659802411
Name:CEBERT, MORINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:MORINE
Middle Name:
Last Name:CEBERT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SANDS PL
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-6610
Mailing Address - Country:US
Mailing Address - Phone:203-280-3162
Mailing Address - Fax:
Practice Address - Street 1:3380 MAIN ST STE 2S
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4860
Practice Address - Country:US
Practice Address - Phone:203-280-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily