Individual
KATELAND HEIDI KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 OLD PARK LANE RD, NEW MILFORD, CT 06776-2507
(860) 355-1149
(860) 210-2008
Mailing address
11 OLD PARK LANE RD, NEW MILFORD, CT 06776-2507
(860) 355-1149
(860) 210-2008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
055.0031323
VT
363A00000X
Physician Assistant
Primary
5214
CT
Other
Enumeration date
05/04/2011
Last updated
04/19/2024
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