Individual
MISS WILMAGIE N BERNACET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
109 VANCE RD, BRISTOL, CT 06010-3744
(203) 819-3821
Mailing address
109 VANCE RD, BRISTOL, CT 06010-3744
(203) 819-3821
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
42189
CT
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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