Provider Demographics
NPI:1932126398
Name:VARZOS, KATINA E (CNM, PMHNP)
Entity Type:Individual
Prefix:
First Name:KATINA
Middle Name:E
Last Name:VARZOS
Suffix:
Gender:F
Credentials:CNM, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4461 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-3604
Mailing Address - Country:US
Mailing Address - Phone:203-314-6075
Mailing Address - Fax:203-208-0688
Practice Address - Street 1:4461 DURHAM RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-3604
Practice Address - Country:US
Practice Address - Phone:203-643-8053
Practice Address - Fax:203-643-8004
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN567041163W00000X
PAMW010105176B00000X
CT000323367A00000X
CT004824363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife