Provider Demographics
NPI:1871978593
Name:OVESNY, MICHELLE E (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:OVESNY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 DICKINSON DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6508
Mailing Address - Country:US
Mailing Address - Phone:781-948-8819
Mailing Address - Fax:
Practice Address - Street 1:90 DICKINSON DR
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6508
Practice Address - Country:US
Practice Address - Phone:781-948-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily