Individual
GRACE GILLETTE STAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1075 ASYLUM AVE, HARTFORD, CT 06105-2455
(978) 578-3974
Mailing address
8 RAYMOND ST, MANCHESTER, MA 01944-1613
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
211972
CT
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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