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Individual

KATELYN MADELINE WIRTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
285 MAIN ST, WEST HAVEN, CT 06516-7307
(203) 503-3000
Mailing address
400 COLUMBUS AVENUE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-3183

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9910
CT

Other

Enumeration date
06/16/2021
Last updated
09/16/2021
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