Individual
KRISTINA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
469 MIGEON AVE, TORRINGTON, CT 06790-4643
(860) 489-0931
Mailing address
469 MIGEON AVE, TORRINGTON, CT 06790-4643
(860) 489-0931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12148
CT
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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