Individual
STACEY ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3746
(860) 644-4241
Mailing address
525 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3746
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8993
CT
Other
Enumeration date
05/26/2020
Last updated
09/30/2020
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