Individual
MRS. STEPHANIE MELISSA FONTANELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
428 HARTFORD TPKE STE 207, VERNON, CT 06066-4841
(860) 872-5426
Mailing address
428 HARTFORD TPKE STE 207, VERNON, CT 06066-4841
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
112872
CT
363L00000X
Nurse Practitioner
Primary
8324
CT
363L00000X
Nurse Practitioner
RN2324164
MA
Other
Enumeration date
06/16/2019
Last updated
08/16/2021
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