Provider Demographics
NPI:1639657273
Name:SMART, DANA ERIN (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:ERIN
Last Name:SMART
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:ERIN
Other - Last Name:JUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:388 E MAIN ST STE 22L
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-2914
Mailing Address - Country:US
Mailing Address - Phone:475-414-1772
Mailing Address - Fax:814-298-5414
Practice Address - Street 1:388 E MAIN ST STE 22L
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2914
Practice Address - Country:US
Practice Address - Phone:203-247-5895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7852363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health