Provider Demographics
NPI:1245636877
Name:GUNNOUD, STEPHANIE LAUREN (APRN)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:GUNNOUD
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1836
Mailing Address - Country:US
Mailing Address - Phone:203-758-8107
Mailing Address - Fax:203-568-2925
Practice Address - Street 1:1625 STRAITS TPKE
Practice Address - Street 2:SUITE 110
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1836
Practice Address - Country:US
Practice Address - Phone:203-758-8107
Practice Address - Fax:203-568-2925
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2017-12-14
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Provider Licenses
StateLicense IDTaxonomies
CT05969363LA2200X
CT0058973363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health