Provider Demographics
NPI:1952888398
Name:DELUCA, AMY ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:ELIZABETH
Last Name:DELUCA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HARTFORD HEALTHCARE-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:584 NORWICH RD STE 300
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:CT
Practice Address - Zip Code:06374-1727
Practice Address - Country:US
Practice Address - Phone:860-230-0020
Practice Address - Fax:860-230-0021
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2273293OtherMASSACHUSETTS BOARD OF REGISTRATION IN NURSING