Provider Demographics
NPI:1457724056
Name:FAIRFIELD HEALTH AND WELLNESS SOLUTIONS, LLC
Entity Type:Organization
Organization Name:FAIRFIELD HEALTH AND WELLNESS SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEENNA
Authorized Official - Middle Name:MONICA
Authorized Official - Last Name:NEALON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-220-6306
Mailing Address - Street 1:324 ELM ST
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2280
Mailing Address - Country:US
Mailing Address - Phone:203-220-6306
Mailing Address - Fax:203-220-6308
Practice Address - Street 1:324 ELM ST
Practice Address - Street 2:SUITE 203A
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-2280
Practice Address - Country:US
Practice Address - Phone:203-220-6306
Practice Address - Fax:203-220-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001767363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty