Individual
KATHERINE ELIZABETH PROVAZNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1260 SILAS DEANE HWY STE 101, WETHERSFIELD, CT 06109-4363
(860) 545-7550
Mailing address
1260 SILAS DEANE HWY STE 101, WETHERSFIELD, CT 06109-4363
(860) 545-7550
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
82532
CT
2084P0800X
Psychiatry Physician
2974
WI
2084P0800X
Psychiatry Physician
Primary
82532
CT
Other
Enumeration date
03/19/2019
Last updated
02/04/2026
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