Individual
LAURA MARY BOANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
121 WAKELEE AVE, ANSONIA, CT 06401-1198
(203) 503-3570
(203) 503-3297
Mailing address
131 MARSHALL LN, DERBY, CT 06418-2347
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
E54146
CT
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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