Individual
LISA MARIE GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
230 BOSTON POST RD, MADISON, CT 06443-2225
(203) 245-0496
(203) 245-8697
Mailing address
230 BOSTON POST RD, MADISON, CT 06443-2225
(203) 245-0496
(203) 245-8697
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
002510
CT
363LP0200X
Pediatric Nurse Practitioner
002510
CT
Other
Enumeration date
03/16/2006
Last updated
08/09/2013
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