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Shady Taveras, LPN
Licensed Practical Nurse in Bridgeport, Connecticut
NPI 1730501727

Shady Taveras is a Licensed Practical Nurse based in New Haven, CT. Shady Taveras practices in Bridgeport, CT and has the professional credentials of LPN. The NPI Number for Shady Taveras is 1730501727 and holds a License No. 33715 (Connecticut).

The current practice location address for Shady Taveras is 425 Grant St, Bridgeport, CT and can be reached out via phone at 203-781-4600 and via fax at 203-781-4624.

Location: 425 Grant St, Bridgeport, CT, 06511-5991
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730501727
Provider Name
Shady Taveras
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
425 Grant St, Bridgeport, CT, 06511-5991
Phone Number
203-781-4600
Fax Number
203-781-4624
Provider Enumeration Date
01/10/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
008024427 05 CT
008023170 05 CT
008042339 05 CT
institution
Provider Business Practice Location Address Details
Address
425 Grant St
City
Bridgeport
State
Connecticut
Zip
06610-3222
Phone Number
203-781-4600
Fax Number
203-781-4624
person
Provider Business Mailing Address Details
Address
425 Grant St
City
Bridgeport
State
Connecticut
Zip
06610-3222
Phone Number
203-781-4600
Fax Number
203-781-4624
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
33715 (Connecticut)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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