Provider Demographics
NPI:1962761395
Name:LEMMA, KATHLEEN MARIE (APRN, MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARIE
Last Name:LEMMA
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-BC
Other - Prefix:
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Mailing Address - Street 1:830 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5222
Mailing Address - Country:US
Mailing Address - Phone:203-380-5270
Mailing Address - Fax:203-291-3800
Practice Address - Street 1:999 SILVER LN
Practice Address - Street 2:3RD FLOOR
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5343
Practice Address - Country:US
Practice Address - Phone:203-380-5270
Practice Address - Fax:203-380-5282
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT004814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1962761395Medicaid