Provider Demographics
NPI:1457752107
Name:PLAPETTA DAMODHARAN, KRIPA (DNP-FNP)
Entity Type:Individual
Prefix:DR
First Name:KRIPA
Middle Name:
Last Name:PLAPETTA DAMODHARAN
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 CAMPBELL AVE STE F
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-3786
Mailing Address - Country:US
Mailing Address - Phone:203-443-9500
Mailing Address - Fax:203-902-0509
Practice Address - Street 1:764 CAMPBELL AVE STE F
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-3786
Practice Address - Country:US
Practice Address - Phone:203-443-9500
Practice Address - Fax:203-902-0509
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008055517Medicaid
CT004235900Medicaid