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Individual

DIANE ROBERTO-NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
105 WEST RD, ELLINGTON, CT 06029-3777
(860) 872-7854
(860) 870-7944
Mailing address
100 ERIC DR, COVENTRY, CT 06238-1327
(860) 742-6320

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
000131
CT

Other

Enumeration date
07/26/2006
Last updated
07/08/2007
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