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Individual

BRITTANY BAYNE WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
290 WESTERN BLVD, GLASTONBURY, CT 06033-1236
(860) 652-3325
Mailing address
187 E CHIPPENS HILL RD, BURLINGTON, CT 06013-2111
(860) 502-7005

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
14871
CT
363LP0200X
Pediatric Nurse Practitioner
RN2361529
MA

Other

Enumeration date
11/03/2023
Last updated
02/06/2026
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