Individual
MS. DEBRA M DIVENERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP
Contact information
Practice address
134 GRANDVIEW AVE, SUITE 208, WATERBURY, CT 06708-2507
(203) 755-3279
(203) 755-3057
Mailing address
25 WINSTON CT, BRISTOL, CT 06010-2691
(860) 585-7063
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0002590
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004224036
—
CT
Enumeration date
07/31/2006
Last updated
07/08/2007
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