Individual
KATHERINE MICIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 AIRCRAFT RD, MIDDLETOWN, CT 06457-5723
(860) 344-5172
Mailing address
1 AIRCRAFT RD, MIDDLETOWN, CT 06457-5723
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8870
CT
Other
Enumeration date
05/18/2020
Last updated
10/18/2022
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