Individual
SIERRA BOULEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
360 UNIVERSAL DR N, NORTH HAVEN, CT 06473-3163
(203) 200-7134
Mailing address
360 UNIVERSAL DR N, NORTH HAVEN, CT 06473-3163
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
143580
CT
363L00000X
Nurse Practitioner
Primary
10445
CT
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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