Individual
MARIAH LATZKA ANAGNOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
283 N MAIN ST, WALLINGFORD, CT 06492-3715
(203) 697-2203
Mailing address
283 N MAIN ST, WALLINGFORD, CT 06492-3715
(203) 697-2203
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0000000
CT
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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