Individual
ELLEN M FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
40 CROSS ST, NORWALK, CT 06851-4647
(203) 229-2000
(203) 840-9001
Mailing address
40 CROSS ST, NORWALK, CT 06851-4647
(203) 229-2000
(203) 840-9001
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
003297
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
003297
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08047561
—
CT
Enumeration date
03/30/2007
Last updated
01/25/2017
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