Provider Demographics
NPI:1548092414
Name:VESSEL HEALING COLLECTIVE PLLC
Entity type:Organization
Organization Name:VESSEL HEALING COLLECTIVE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAMMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:203-675-5308
Mailing Address - Street 1:443 NORTON PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2830
Mailing Address - Country:US
Mailing Address - Phone:203-675-5308
Mailing Address - Fax:
Practice Address - Street 1:443 NORTON PKWY
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2830
Practice Address - Country:US
Practice Address - Phone:203-675-5308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty