Individual
MELISSA BOHAN-HALLENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 456-6965
(860) 456-6969
Mailing address
5 CHARLES ST, PUTNAM, CT 06260-2003
(860) 420-8150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5798
CT
363L00000X
Nurse Practitioner
RN2311497
MA
Other
Enumeration date
07/28/2014
Last updated
01/15/2018
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