Individual
THAMARA VANESSA JONATHAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
140 N FRONTAGE RD, MANSFIELD CENTER, CT 06250-1648
(860) 456-2261
Mailing address
1007 N MAIN ST, DAYVILLE, CT 06241-2170
(860) 774-2020
(860) 477-4708
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7176
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008085479
—
CT
Enumeration date
11/06/2017
Last updated
03/27/2023
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