Individual
WENDY MARIKO AWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(475) 210-6177
(475) 210-6146
Mailing address
1290 SILAS DEANE HWY, WETHERSFIELD, CT 06109-4337
(475) 210-6177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
106481
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
7420
CT
Other
Enumeration date
12/29/2017
Last updated
04/07/2022
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