Provider Demographics
| NPI: | 1407231780 |
|---|---|
| Name: | ANNA GUT APRN LLC |
| Entity type: | Organization |
| Organization Name: | ANNA GUT APRN LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CNS/APRN |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ANNA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | GUT |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | CNS, PMH-BC, APRN |
| Authorized Official - Phone: | 860-810-2302 |
| Mailing Address - Street 1: | 502 WHITE PLAINS RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TRUMBULL |
| Mailing Address - State: | CT |
| Mailing Address - Zip Code: | 06611-4857 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 860-810-2302 |
| Mailing Address - Fax: | 203-349-2087 |
| Practice Address - Street 1: | 502 WHITE PLAINS RD BLDG A2 |
| Practice Address - Street 2: | |
| Practice Address - City: | TRUMBULL |
| Practice Address - State: | CT |
| Practice Address - Zip Code: | 06611-4857 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 860-810-2302 |
| Practice Address - Fax: | 203-349-2087 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-07-28 |
| Last Update Date: | 2024-09-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CT | 001319 | 364S00000X, 364SA2200X, 364SC1501X, 364SP0807X, 364SP0808X, 364SP0809X, 364SP0810X, 364SP0811X, 364SP0812X, 364SP0813X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 364SP0808X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 364S00000X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Group - Multi-Specialty | |
| No | 364SA2200X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health | Group - Multi-Specialty |
| No | 364SC1501X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Community Health/Public Health | Group - Multi-Specialty |
| No | 364SP0807X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |
| No | 364SP0809X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Adult | Group - Multi-Specialty |
| No | 364SP0810X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Family | Group - Multi-Specialty |
| No | 364SP0811X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Chronically Ill | Group - Multi-Specialty |
| No | 364SP0812X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Community | Group - Multi-Specialty |
| No | 364SP0813X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Geropsychiatric | Group - Multi-Specialty |
