Individual
JOYNELL MIRASOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-3111
Mailing address
290 TREADWELL ST UNIT 1802, HAMDEN, CT 06517-2360
(203) 506-9339
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
006351
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0061698
CONTROLLED SUBSTANCE PRACTITIONER
CT
01
—
006351
APRN STATE LICENSE
CT
Enumeration date
11/13/2015
Last updated
11/13/2015
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