Individual
DR. MARILYN ANDERSEN RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
333 COLONEL LEDYARD HWY, LEDYARD, CT 06339-1909
(860) 572-7556
(860) 572-2976
Mailing address
333 COLONEL LEDYARD HWY, LEDYARD, CT 06339-1909
(860) 572-7556
(860) 572-2976
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
000795
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002771294
—
CT
Enumeration date
10/19/2006
Last updated
12/07/2011
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