Organization
KEYS2MEMORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELENA SCHJAVLAND APRN (OWNER/PROVIDER)
(860) 245-4144
Entity
Organization
Contact information
Practice address
20 BURROWS ST, MYSTIC, CT 06355-2445
(860) 245-4144
(860) 245-4145
Mailing address
23 EAST MAIN ST., PO BOX 625, MYSTIC, CT 06355-0625
(860) 245-4144
(860) 245-4145
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
002017
CT
363LG0600X
Gerontology Nurse Practitioner
Primary
002017
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004020178
—
CT
Enumeration date
08/14/2012
Last updated
01/07/2014
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