Individual
ALISA B BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 456-9116
Mailing address
257 BACK RD, WINDHAM, CT 06280-1207
(860) 933-0254
(860) 933-0254
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8551
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/08/2019
Last updated
12/11/2019
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