Individual
MRS. LAURA KELLEY KOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
333 CEDAR ST, ROOM WWW305, NEW HAVEN, CT 06510-3206
(203) 785-2660
Mailing address
64 OSPREY DR, GROTON, CT 06340-3132
(214) 926-8608
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4194
CT
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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