Individual
KATHLEEN A ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, DNPC
Contact information
Practice address
30 ORCHARD ST, COS COB, CT 06807-2403
(203) 253-2225
(203) 869-4421
Mailing address
30 ORCHARD ST, COS COB, CT 06807-2403
(203) 253-2225
(203) 869-4421
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
001317
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500000270
—
CT
Enumeration date
02/26/2007
Last updated
09/19/2011
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