Individual
MRS. AVALON DIBNER FENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
120 CONNECTICUT AVE, NORWALK, CT 06854-1525
(203) 899-1770
Mailing address
120 CONNECTICUT AVE, NORWALK, CT 06854-1525
(203) 899-1770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
113331
CT
163W00000X
Registered Nurse
L1-0042593
DE
163W00000X
Registered Nurse
RN61411
ME
163W00000X
Registered Nurse
RN634654
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
5598
CT
Other
Enumeration date
11/05/2013
Last updated
09/30/2014
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