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Individual

KERI ANN KLINK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
512 SAYBROOK RD, SUITE 100, MIDDLETOWN, CT 06457-4788
(860) 347-7636
(860) 894-1882
Mailing address
512 SAYBROOK RD, SUITE 100, MIDDLETOWN, CT 06457-4788
(860) 347-7636
(860) 894-1882

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
002695
CT
363AS0400X
Surgical Physician Assistant
Primary
002695
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008037198
CT
Enumeration date
12/30/2011
Last updated
07/12/2012
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