Theresa G Boothby, MSN, APRN, NP-C
Nurse Practitioner, Family in New London, Connecticut
1053840389- Practice location
- 1 Shaws Cv, New London, CT 06320-4902
- Phone
- 860-447-8304
- Fax
- —
- Last updated
- July 11, 2026
Theresa Grace Boothby is a Nurse Practitioner, Family based in New London, CT. Theresa Grace Boothby practices in New London, CT and has the professional credentials of MSN, APRN, NP-C. The NPI Number for Theresa Grace Boothby is 1053840389 and holds a License No. RN213709 (MA). The current practice location address for Theresa Grace Boothby is 1 Shaws Cv, New London, CT 06320-4902 and can be reached out via phone at 860-447-8304.
Provider Profile Details
- NPI Number
- 1053840389
- Provider Name
- Theresa Grace Boothby
- Credential
- MSN, APRN, NP-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1 Shaws Cv, New London, CT 06320-4902
- Phone Number
- 860-447-8304
- Primary Taxonomy
- Nurse Practitioner, Family · 363LF0000X
- Sole Proprietor
- No
- Provider Enumeration Date
- June 9, 2017
- Last Update Date
- July 11, 2026
- Certification Date
- July 11, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Shaws Cv
New London, CT 06320-4902 - City
- New London
- State
- Connecticut
- Zip
- 06320-4902
- Phone Number
- 860-447-8304
Provider Business Mailing Address Details
- Address
- 16 Westside Dr Apt 117
North Grosvenordale, CT 06255-2162 - City
- North Grosvenordale
- State
- CT
- Zip
- 06255-2162
- Phone Number
- 508-949-7460
License Information
- License Number (1)
- RN213709
- License State (1)
- MA
- Taxonomy (1)
- Registered Nurse · 163W00000X
- License Number (2)
- 12.010276
- License State (2)
- CT
- Taxonomy (2)
- Nurse Practitioner, Family · 363LF0000X
- License Number (3)
- 10.187256
- License State (3)
- CT
- Taxonomy (3)
- Registered Nurse · 163W00000X
- License Number (4)
- RN213709
- License State (4)
- MA
- Taxonomy (4)
- Nurse Practitioner, Family · 363LF0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Theresa G Boothby, MSN, APRN, NP-C?
The NPI number of Theresa G Boothby, MSN, APRN, NP-C is 1053840389. It was assigned on June 9, 2017 and is currently active in the NPPES registry.
What is the specialty of Theresa G Boothby, MSN, APRN, NP-C?
Theresa G Boothby, MSN, APRN, NP-C is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X), licensed in MA under license number RN213709.
Where does Theresa G Boothby, MSN, APRN, NP-C practice?
The practice location is 1 Shaws Cv, New London, CT 06320-4902. The office can be reached at 860-447-8304 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1053840389 directly on the NPPES registry website.