Individual
MS. MARY ELLEN PAGNOZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
3 HERON RD, MYSTIC, CT 06355-3253
(860) 536-6442
(860) 536-6442
Mailing address
3 HERON RD, MYSTIC, CT 06355-3253
(860) 536-6442
(860) 536-6442
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
001588
CT
363LG0600X
Gerontology Nurse Practitioner
001588
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004203329
—
CT
Enumeration date
07/14/2006
Last updated
12/16/2015
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