Provider Demographics
NPI:1760933923
Name:WHELAN-MORIN, NATHAN TODD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:TODD
Last Name:WHELAN-MORIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:NATHAN
Other - Middle Name:TODD
Other - Last Name:MCDELAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HARTFORD HEALTHCARE-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR ST BLDG 502
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-972-0549
Practice Address - Fax:860-545-5221
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084760363AM0700X
CT5927363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical