Provider Demographics
NPI:1285276352
Name:DANSO, EVELYN KUMAH (APNR)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:KUMAH
Last Name:DANSO
Suffix:
Gender:F
Credentials:APNR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PERKINS FARM DR
Mailing Address - Street 2:STE 102
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-4041
Mailing Address - Country:US
Mailing Address - Phone:203-631-3273
Mailing Address - Fax:
Practice Address - Street 1:44 MAPLEHURST CT
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1576
Practice Address - Country:US
Practice Address - Phone:203-631-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8533363L00000X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal