Individual
SHIRLEY JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1389 W MAIN ST STE 302, WATERBURY, CT 06708-3115
(203) 687-5668
(860) 489-2604
Mailing address
PO BOX 1892, NAUGATUCK, CT 06770-8602
(203) 687-5668
(860) 489-2604
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
093616
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
006959
CT
Other
Enumeration date
02/13/2017
Last updated
09/23/2021
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