Individual
NICOLE FEARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2639 MAIN ST, GLASTONBURY, CT 06033-2023
(860) 659-1329
Mailing address
99 BEAMAN BRK, BLOOMFIELD, CT 06002-4005
(860) 371-6636
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
005480
CT
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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