Individual
MARTINE THELUSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 SUCCESS AVE APT 28, BRIDGEPORT, CT 06610-2442
(678) 548-0095
Mailing address
500 SUCCESS AVE APT 28, BRIDGEPORT, CT 06610-2442
(678) 548-0095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
143284
CT
163W00000X
Registered Nurse
291815
GA
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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