Provider Demographics
NPI:1366297178
Name:SILVA, ANA MARISIA (APRN)
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:MARISIA
Last Name:SILVA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 EUSTIS ST
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-1313
Mailing Address - Country:US
Mailing Address - Phone:203-217-4653
Mailing Address - Fax:
Practice Address - Street 1:1312 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3121
Practice Address - Country:US
Practice Address - Phone:203-709-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2024000329363LX0106X
CT13261363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health