Provider Demographics
NPI:1336262989
Name:BARTOS, CARA MARIE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:MARIE
Last Name:BARTOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:CARA
Other - Middle Name:MARIE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:124 SIMSBURY ROAD
Mailing Address - Street 2:9-B
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001
Mailing Address - Country:US
Mailing Address - Phone:860-463-6128
Mailing Address - Fax:860-529-4592
Practice Address - Street 1:152 SIMSBURY ROAD
Practice Address - Street 2:BUILDING 9
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001
Practice Address - Country:US
Practice Address - Phone:860-463-6128
Practice Address - Fax:860-529-4592
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002651364SP0808X, 364SP0807X
SC18553163W00000X, 364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse