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Individual

LAURA SUNDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
374 GRAND AVE, FAIR HAVEN COMMUNITY HEALTH CENTER, NEW HAVEN, CT 06513
(203) 777-7411
Mailing address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 777-7411
(203) 777-5910

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
000279
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004235900
CT
Enumeration date
03/14/2006
Last updated
02/11/2009
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