Provider Demographics
NPI:1396757902
Name:MESINGER, ANN S (APRN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:MESINGER
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 1:324 ELM ST
Mailing Address - Street 2:STE. 202B
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2280
Mailing Address - Country:US
Mailing Address - Phone:203-880-5335
Mailing Address - Fax:203-907-1234
Practice Address - Street 1:324 ELM ST
Practice Address - Street 2:STE 202B
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-5163
Practice Address - Country:US
Practice Address - Phone:203-880-5335
Practice Address - Fax:203-907-1234
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001451363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP30838Medicare UPIN
CT5000008Medicare ID - Type Unspecified