Individual
EMILY KATHRYN STAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 533-3494
Mailing address
98 LANCASTER RD, GLASTONBURY, CT 06033-1123
(203) 314-9339
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
03277675
CT
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
092976
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008037446
—
CT
Enumeration date
08/03/2011
Last updated
12/09/2022
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