Individual
MAURICE EDWARDS BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
232 CEDAR ST, NEW HAVEN, CT 06519-1610
(203) 503-3300
Mailing address
232 CEDAR ST, NEW HAVEN, CT 06519-1610
(203) 503-3300
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
002910
CT
363LP2300X
Primary Care Nurse Practitioner
2910
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008050090
BUNNELL MEDICAID
CT
01
—
D400292158
BUNNELL MEDICARE
CT
Enumeration date
11/19/2009
Last updated
10/27/2016
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