Provider Demographics
NPI:1972140051
Name:UVA, ANA C (APRN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:C
Last Name:UVA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:ANA
Other - Middle Name:C
Other - Last Name:UVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN
Mailing Address - Street 1:1647 MUSSO VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1027
Mailing Address - Country:US
Mailing Address - Phone:203-804-7277
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty