Individual provider · Type 1 NPI

Renee Patrice Divine

Psychiatric/Mental Health Nurse Practitioner · Fairfield, CT

NPI number 1245028521 Active

Practice location

1073 N Benson Rd
Fairfield, CT 06824-5195

Mailing address

95 Rockland Ave
Stratford, CT 06614-3117

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNA (CT)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1245028521

Renee Patrice Divine's National Provider Identifier is 1245028521, issued on Apr 28, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fairfield, CT. The record was last updated on Apr 28, 2025.