Individual
MARY F. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
GAYLORD FARMS RD., WALLINGFORD, CT 06492
(203) 284-2800
(203) 679-3598
Mailing address
GAYLORD FARMS RD., PO BOX 400, WALLINGFORD, CT 06492
(203) 284-2800
(203) 679-3598
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
001305
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001305
STATE LICENSE
CT
01
—
029407
SUBSTANCE CONTROLLED LIC.
CT
Enumeration date
10/11/2006
Last updated
03/07/2023
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