Individual
KRISTY VICTORIA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
189 STORRS RD, MANSFIELD CENTER, CT 06250-1683
(203) 621-4773
Mailing address
26 BOSTON POST RD, # 188, WATERFORD, CT 06385-2402
(203) 621-4773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
082694
CT
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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