Individual
MRS. ELISE KATHERINE SPALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 SCOTT SWAMP RD, FARMINGTON, CT 06032-3124
(860) 751-6265
Mailing address
175 SCOTT SWAMP RD, FARMINGTON, CT 06032-3124
(860) 751-6265
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
88959
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811520810
—
CT
Enumeration date
03/30/2020
Last updated
03/30/2020
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