NPI 1003280157 · live from the CMS NPI Registry
A Prospering Vision Holistic Medical Services, LLC
Nurse Practitioner in Waterbury, CT. National Provider Identifier 1003280157, active.
NPI record
| NPI | 1003280157 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 60 N Main St, 3rd Flr, Waterbury, CT 06702 |
| Practice phone | 203-558-9865 |
| Enumerated | November 30, 2015 |
| Last updated | November 30, 2015 |
| Authorized official | Elijah Caldwell, Executive Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.