Individual
SHANIKA DESMOULIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
31 BROOKLAWN PL, BRIDGEPORT, CT 06604-2117
(917) 651-9240
Mailing address
31 BROOKLAWN PL, BRIDGEPORT, CT 06604-2117
(917) 651-9240
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
738515
NY
164W00000X
Licensed Practical Nurse
320771
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3819392
NY
Other
Enumeration date
02/17/2015
Last updated
05/20/2026
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