Individual
KRISTIN D MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
208 VALLEY RD, NEW CANAAN, CT 06840-3812
(866) 542-4455
Mailing address
208 VALLEY RD, NEW CANAAN, CT 06840-3812
(866) 542-4455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
7564
WI
363L00000X
Nurse Practitioner
Primary
8730
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760916761
—
WI
01
—
K400387628
MEDICARE
WI
Enumeration date
04/17/2017
Last updated
08/21/2020
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