Provider Demographics
NPI:1922832955
Name:DELAIRE, CAROLINA VICTORIA (RN)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:VICTORIA
Last Name:DELAIRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 OLD ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-1366
Mailing Address - Country:US
Mailing Address - Phone:860-324-5573
Mailing Address - Fax:
Practice Address - Street 1:103 OLD ANDOVER RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:CT
Practice Address - Zip Code:06248-1366
Practice Address - Country:US
Practice Address - Phone:860-324-5573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT098121163WC1500X
CT12.014703363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health