Individual
COLLETTE KEISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38 CARSON WAY, SOUTH WINDSOR, CT 06074-1847
(860) 680-6898
Mailing address
38 CARSON WAY, SOUTH WINDSOR, CT 06074-1847
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5596
CT
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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