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Individual

SUSAN CLAYTON BALLOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
3 HILLCREST PARK RD, OLD GREENWICH, CT 06870-1003
(203) 202-7532
Mailing address
3 HILLCREST PARK RD, OLD GREENWICH, CT 06870-1003
(203) 202-7532

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
004268
CT

Other

Enumeration date
09/21/2011
Last updated
09/21/2011
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