Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elise Mae Fernstrom

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1083411904

Elise Mae Fernstrom is a Nurse Practitioner in Norwich, Connecticut. Qualified in 2024, 2 years ago. Practices with Harvest Healthcare LLC, a 70-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
2
Licensed in
CT
In the registry since
2025

Practice location Address checks out

401 W Thames St Bldg 301
Norwich, CT 06360-7155
Phone: (860) 859-4563
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 14409 (CT)

Record details

NPI number1083411904
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 27, 2025
Last updated in NPPESFebruary 27, 2025
Certification dateFebruary 27, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Harvest Healthcare Llc — 70 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Norwich