Individual
VIRGINIA HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
22 OLD WATERBURY RD, SOUTHBURY, CT 06488-3848
(203) 262-4244
Mailing address
22 OLD WATERBURY RD, SOUTHBURY, CT 06488-3848
(203) 262-4244
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
001429
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00268688
RAILROAD MEDICARE
CT
Enumeration date
09/29/2006
Last updated
07/08/2007
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