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

Katherine Miciak

Individual provider Family Nurse Practitioner · NPI 1649892274

Katherine Miciak is a Nurse Practitioner in Middletown, Connecticut. Qualified in 2020, 6 years ago. Practices with Novella Medicine Services of Massachusetts PLLC, a 27-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Connecticut.

Years since qualifying
6
Licensed in
CT
In the registry since
2020
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Practice location Address checks out

1 Aircraft Rd
Middletown, CT 06457-5723
Phone: (860) 344-5172
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 8870 (CT)

Record details

NPI number1649892274
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 18, 2020
Last updated in NPPESOctober 18, 2022
Certification dateOctober 18, 2022
Mailing address1 Aircraft Rd, Middletown, CT 06457-5723

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Novella Medicine Services Of Massachusetts Pllc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Middletown