Individual
MS. JOHANNA L MEEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
114 WOODLAND ST, CANCER CENTER, HARTFORD, CT 06105-1208
(860) 714-5554
(860) 714-8047
Mailing address
130 BRAEMAR DR, CHESHIRE, CT 06410-1614
(203) 271-1389
(860) 496-4951
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
843
CT
364SX0200X
Oncology Clinical Nurse Specialist
000843
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000843
APRN
CT
01
—
21885
CT CONTROLLED SUBSTANCE
CT
05
—
4190435
—
CT
01
—
R39729
RN LICENSE
CT
Enumeration date
07/12/2006
Last updated
03/07/2023
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