Provider Demographics
NPI:1912336462
Name:DUFFY-HIDALGO, BOBBI (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BOBBI
Middle Name:
Last Name:DUFFY-HIDALGO
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 1:136 OSBORN LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2516
Mailing Address - Country:US
Mailing Address - Phone:203-452-0493
Mailing Address - Fax:
Practice Address - Street 1:830 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5222
Practice Address - Country:US
Practice Address - Phone:203-452-0493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily