Individual
SELMA COSTA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
117 DOWD ST, NEWINGTON, CT 06111-2608
(860) 250-9017
Mailing address
117 DOWD ST, NEWINGTON, CT 06111-2608
(860) 250-9017
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12.009476
CT
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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