Individual
AUDREY BAKANAUSKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
114 WOODLAND ST, CARDIOLOGY, HARTFORD, CT 06105-1208
(860) 714-4161
(860) 714-8001
Mailing address
1000 ASYLUM AVE, SUITE 2109A, HARTFORD, CT 06105-1770
(860) 714-6581
(860) 714-8311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001638
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004197639
—
CT
Enumeration date
08/12/2005
Last updated
02/17/2012
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