Provider Demographics
NPI:1487179032
Name:MANNIL, BEENU (DNP, APRN, PMHNP)
Entity type:Individual
Prefix:
First Name:BEENU
Middle Name:
Last Name:MANNIL
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP
Other - Prefix:
Other - First Name:BEENU
Other - Middle Name:
Other - Last Name:KARUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APRN, PMHNP
Mailing Address - Street 1:72 NORTH STREET, STE 103
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:203-748-1200
Mailing Address - Fax:203-790-0010
Practice Address - Street 1:152 WEST ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6361
Practice Address - Country:US
Practice Address - Phone:203-743-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7108363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health