Provider Demographics
NPI:1457157877
Name:DANIELS, CHRISTINE H (MS, APRN, AGNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:H
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MS, APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-1553
Mailing Address - Country:US
Mailing Address - Phone:860-716-6337
Mailing Address - Fax:
Practice Address - Street 1:1210 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4328
Practice Address - Country:US
Practice Address - Phone:860-721-5731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT95731163W00000X
MARN10014923163W00000X
CT15027363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse