Unknown Individual – Psychiatric/Mental Health Nurse Practitioner, NPI 1124011853

Unknown Individual is a healthcare provider. based in Branford, Connecticut. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold a License No. 363LP0808X (CT). The NPI Number for Unknown Individual is 1124011853

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124011853
Phone
(888) 616-8563
Address
PO BOX 194
Deactivation Date
18 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1977 (49 years ago)
PAC ID
7315113057
Professional Enrollment ID
I20111230000538
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Branford, New Haven County, Connecticut, United States

    BRANFORD, CT 064050194

    Phone: (888) 616-8563

    Fax: (203) 481-4217

    Type: Mailing

  • 1, South Main Street, Branford Center, Branford, New Haven County, Connecticut, 06405, United States

    BRANFORD, CT 064053872

    Phone: (888) 616-8563

    Fax: (203) 481-4217

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06405)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1124011853 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Branford, Connecticut.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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