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DEBORAH STALEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
357 HARTFORD TPKE, VERNON, CT 06066-4838
(860) 871-2102
(860) 870-0890
Mailing address
PO BOX 3249, VERNON, CT 06066-2149
(860) 896-1422
(860) 896-1425

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
001199
CT
363LP0200X
Pediatric Nurse Practitioner
Primary
001199
CT

Other

Enumeration date
03/10/2006
Last updated
06/18/2009
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