Individual
MALLORY BENKERT MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, NP-C
Contact information
Practice address
2400 TAMARACK AVE STE 101, SOUTH WINDSOR, CT 06074-5556
(860) 644-4442
Mailing address
19 PEMBROKE HL, FARMINGTON, CT 06032-1461
(757) 576-6944
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
8015
CT
Other
Enumeration date
02/11/2019
Last updated
12/28/2021
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