Individual
CASEY ST. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
1301 FARMINGTON AVE, BRISTOL, CT 06010-4776
(860) 589-4501
Mailing address
340 N MAIN ST, SOUTHINGTON, CT 06489-2565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10725
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37-1552719
—
CT
Enumeration date
11/16/2022
Last updated
11/16/2022
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