Provider Demographics
NPI:1265928154
Name:LONEGAN, EILEEN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:LONEGAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-1312
Mailing Address - Country:US
Mailing Address - Phone:203-910-1826
Mailing Address - Fax:
Practice Address - Street 1:127 PINES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BEACON FALLS
Practice Address - State:CT
Practice Address - Zip Code:06403-1017
Practice Address - Country:US
Practice Address - Phone:203-881-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.007660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily