IndividualActive
Renee Provost, APRN
NPI 1386970598 · Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist · Glastonbury, CT
Provider details
- NPI number
- 1386970598
- Entity type
- Individual
- Primary specialty
- Geropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- License
- 01998 (CT)
Practice location
55 Nye Rd Ste 102
Glastonbury, CT 06033-1281
Phone: (860) 657-3056
Fax: (860) 633-3517
Mailing address
55 Nye Rd Ste 102
Glastonbury, CT 06033-1281
Registry dates
- Enumerated
- 2009-10-22
- Last updated
- 2009-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.