Individual
EDA TOPI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11 ALSCOT DR, EAST LYME, CT 06333-1303
(860) 910-7779
Mailing address
11 ALSCOT DR, EAST LYME, CT 06333-1303
(860) 910-7779
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
12589
CT
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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