Individual
MARY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 N MAIN ST, ENFIELD, CT 06082-3339
(860) 253-9024
(860) 253-9593
Mailing address
635 MAIN ST, ATTN: CREDENTIALING DPT, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R32071
CT
Other
Enumeration date
11/01/2007
Last updated
11/01/2007
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