Individual
KATHRYN M MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1291 BOSTON POST RD, SUITE 105, MADISON, CT 06443-3476
(203) 245-1413
(860) 358-8655
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4820
(860) 358-8661
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
002139
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4201092
—
CT
Enumeration date
11/01/2006
Last updated
04/12/2017
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