Basic Information
| Provider Information | |||||||||
| NPI: | 1093749160 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MESSNER | ||||||||
| FirstName: | JOAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46 PRINCE ST | ||||||||
| Address2: | #207 | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065191600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037872264 | ||||||||
| FaxNumber: | 2037875667 | ||||||||
| Practice Location | |||||||||
| Address1: | 46 PRINCE ST | ||||||||
| Address2: | #207 | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065191600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037872264 | ||||||||
| FaxNumber: | 2037875667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 02/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 000196 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | P3204354 | 01 | CT | OXFORD | OTHER | 400000196C701 | 01 | CT | BC | OTHER |