Individual
KAREN M MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, UCONN MEDICAL GROUP, ORTHOPAEDICS, FARMINGTON, CT 06030-0001
(860) 679-6600
(860) 679-6604
Mailing address
65 KANE ST, PROVIDER ENROLLMENT, 2ND FLOOR, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3701
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
02247
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4220480
—
CT
Enumeration date
06/28/2005
Last updated
08/24/2012
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