Individual
MRS. LISSY DAVIS POULOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
324 ELM ST, STE 202B, MONROE, CT 06468-2284
(203) 880-5335
(203) 907-1234
Mailing address
324 ELM ST, STE 202B, MONROE, CT 06468-2284
(203) 880-5335
(203) 907-1234
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
003902
CT
Other
Enumeration date
10/22/2008
Last updated
01/21/2022
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