Provider Demographics
NPI:1023797016
Name:SVYSTUN, COLLEEN BOZENA (APRN)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:BOZENA
Last Name:SVYSTUN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:COLLEEN
Other - Middle Name:BOZENA
Other - Last Name:PADYKULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:945 MAIN ST STE 212
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6064
Mailing Address - Country:US
Mailing Address - Phone:860-649-6166
Mailing Address - Fax:860-649-6186
Practice Address - Street 1:945 MAIN ST STE 212
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6064
Practice Address - Country:US
Practice Address - Phone:860-967-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT154455163W00000X
CT12195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse