Individual
KENNETH KOELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
365 MONTAUK AVE, ANESTHESIA DEPT., NEW LONDON, CT 06320-4700
(860) 442-0711
Mailing address
PO BOX 32928, ANESTHESIA ASSOC OF NEW LONDON, HARTFORD, CT 06150-2928
(800) 720-1664
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
000199
CT
Other
Enumeration date
10/10/2006
Last updated
02/01/2008
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