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

Mrs. Renee Patrice Divine

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1245028521

Mrs. Renee Patrice Divine is a Nurse Practitioner in Fairfield, Connecticut. Qualified in 2025, 1 year ago. Licensed in Connecticut.

Years since qualifying
1
Licensed in
CT
In the registry since
2025
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Practice location Address checks out

1073 N Benson Rd
Fairfield, CT 06824-5195
Phone: (203) 254-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

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

Record details

NPI number1245028521
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 28, 2025
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025
Mailing address95 Rockland Ave, Stratford, CT 06614-3117

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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