Provider Demographics
NPI:1427670546
Name:KALINOWSKI, CHARLENE (APRN)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:
Last Name:KALINOWSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:
Other - Last Name:ROZYCKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 SCOTT LN
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-1264
Mailing Address - Country:US
Mailing Address - Phone:860-227-0638
Mailing Address - Fax:
Practice Address - Street 1:455 LEWIS AVE STE 221
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2121
Practice Address - Country:US
Practice Address - Phone:203-694-8550
Practice Address - Fax:203-694-7698
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily