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Individual

MRS. DEANNA MICHAUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
70 HEMINWAY PARK RD, WATERTOWN, CT 06795-2612
(203) 709-5925
Mailing address
378 JEROME AVE, BURLINGTON, CT 06013-2434
(860) 490-5953

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001269
CT
363AM0700X
Medical Physician Assistant
Primary
001269
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004245272
CT
01
010269
CONNECTICARE
CT
01
1192828
USA
CT
01
7346891
AETNA
CT
01
PENDING
RR MEDICARE
CT
Enumeration date
01/23/2006
Last updated
08/17/2023
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