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Individual

RENEE PROVOST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
55 NYE RD STE 102, GLASTONBURY, CT 06033-1281
(860) 657-3056
(860) 633-3517
Mailing address
55 NYE RD STE 102, GLASTONBURY, CT 06033-1281
(860) 657-3056
(860) 633-3517

Taxonomy

Speciality
Code
Description
License number
State
364SP0813X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
Primary
01998
CT

Other

Enumeration date
10/22/2009
Last updated
10/22/2009
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