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Individual

SUSAN MARKHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
31 SYCAMORE ST, SUITE 201-B, GLASTONBURY, CT 06033-4540
(860) 659-0629
(860) 714-6698
Mailing address
31 SYCAMORE ST, SUITE 201-B, GLASTONBURY, CT 06033-4540
(860) 659-0629
(860) 714-6698

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001758
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001758
CT STATE LICENSE
CT
Enumeration date
02/09/2006
Last updated
10/29/2007
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