NPI 1083317390

Regenerise Health LLC

Organisation Clinic/Center Wallingford, CT

Practice location

Address: 300 Church St, Wallingford, CT 06492-2253
Phone: (860) 994-7339
Mailing address: 300 Church St STE 103, Wallingford, CT 06492-2253

Authorised official

Name: Authurine Hannam-Davis
Title: Family Nurse Practitioner
Phone: (860) 994-7339

Registered specialties (2)

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X

Other Clinic/Center providers in Connecticut →

Family Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X

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Registry record

NPI: 1083317390
Entity type: Organization
NPI issued: 24 Mar 2023
Record last updated: 20 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.