Provider Demographics
NPI:1538868245
Name:MASELLI-LUTH, CAMERON L (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:L
Last Name:MASELLI-LUTH
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 RIVENDELL DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4332
Mailing Address - Country:US
Mailing Address - Phone:203-687-8510
Mailing Address - Fax:
Practice Address - Street 1:140 CLARK ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-8427
Practice Address - Country:US
Practice Address - Phone:203-693-4593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily