Individual
KATHLEEN MARY KIRWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
116 S MAIN ST, THE CARRIAGE HOUSE, WALLINGFORD, CT 06492-4217
(203) 697-0807
(203) 265-3651
Mailing address
116 S MAIN ST, THE CARRIAGE HOUSE, WALLINGFORD, CT 06492-4217
(203) 697-0807
(203) 265-3651
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
002756
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3248477
AETNA
CT
01
—
5600002756CT2
ANTHEM
CT
Enumeration date
07/07/2006
Last updated
07/11/2011
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