Provider Demographics
NPI:1396899530
Name:NESPOLI, CLARE MARIE (MS NURSING)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:MARIE
Last Name:NESPOLI
Suffix:
Gender:F
Credentials:MS NURSING
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:MARIE
Other - Last Name:KINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS NURSING
Mailing Address - Street 1:57 NORTH ST
Mailing Address - Street 2:SUITE 309-311
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5660
Mailing Address - Country:US
Mailing Address - Phone:203-743-0100
Mailing Address - Fax:203-731-5268
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE 309-311
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5660
Practice Address - Country:US
Practice Address - Phone:203-743-0100
Practice Address - Fax:203-731-5268
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003236363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT37574OtherCONTROLLER SUBSTANCE CERT
CT8002179Medicaid
CTMK1256040OtherFEDERAL DEA