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Organization

WEVOLVE

Active
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Organization

WEVOLVE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAURICE BUNNELL (AUTHORIZED OFFICIAL)
(475) 202-3318
Entity
Organization

Contact information

Practice address
4 CORPORATE DR STE 396, SHELTON, CT 06484-6266
(475) 202-3450
(203) 712-7130
Mailing address
4 CORPORATE DR STE 396, SHELTON, CT 06484-6266
(475) 202-3450
(203) 712-7130

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—

Other

Enumeration date
11/09/2021
Last updated
02/09/2022
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