Individual
MRS. MIRLENE POLYCARPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, DNP
Contact information
Practice address
50 EASTBURY HILL DR, MIDDLETOWN, CT 06457-8755
(860) 834-0479
Mailing address
85 RETREAT AVENUE, HHCMG/CANCER CENTER/HARTFORD HOSPITAL, HARTFORD, CT 06106-2555
(860) 972-4183
(860) 972-7040
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9761
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2021
Last updated
10/18/2021
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