Provider Demographics
NPI:1740012665
Name:ARENAS, MUGUETTE C (APRN)
Entity type:Individual
Prefix:
First Name:MUGUETTE
Middle Name:C
Last Name:ARENAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SHIPPAN AVE # 201
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-6075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:203-406-4462
Practice Address - Street 1:401 SHIPPAN AVE STE 201
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-6075
Practice Address - Country:US
Practice Address - Phone:203-658-9507
Practice Address - Fax:203-406-4462
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.013720363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner