Individual
KELLIE BUCCETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06106-3315
(203) 710-3992
Mailing address
5 SUSAN DR, WALLINGFORD, CT 06492-1939
(203) 710-3992
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
13699
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2024
Last updated
08/15/2024
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