Individual
ANGELA LYN PRENTISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
52 HAZELNUT HILL RD, GROTON, CT 06340-3268
(860) 446-8265
Mailing address
612 SOUTH STREET, COVENTRY, CT 06238
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
005767
CT
Other
Enumeration date
06/16/2014
Last updated
02/13/2015
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