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Individual

MS. ANNE H AMBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
320 POMFRET ST, PUTNAM, CT 06260-1834
(860) 928-6541
(860) 963-6450
Mailing address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 928-6541
(860) 963-6450

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
000390
CT
367A00000X
Advanced Practice Midwife
000121
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000390
CT LICENSE
CT
05
004200573
CT
01
012100
CONNECTICARE
CT
01
244029
HEALTHNET
CT
01
400CNM121CT01
BC/BS
CT
Enumeration date
10/11/2006
Last updated
11/04/2016
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