Provider Demographics
NPI:1669721965
Name:MARSDEN, DAURIE DEVORE (CRNA, APRN, ACNP)
Entity type:Individual
Prefix:
First Name:DAURIE
Middle Name:DEVORE
Last Name:MARSDEN
Suffix:
Gender:F
Credentials:CRNA, APRN, ACNP
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:DEVORE
Other - Last Name:MARSDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, CRNA, ACNP
Mailing Address - Street 1:74 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1045
Mailing Address - Country:US
Mailing Address - Phone:860-884-2056
Mailing Address - Fax:
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:UNIT CL41- OFFICE 1
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-0680
Practice Address - Country:US
Practice Address - Phone:203-491-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2281597163W00000X, 367500000X
CT087676163W00000X
NYF432794-01363LA2100X
CT5669367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care