Individual
CARLY GENE STAAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
982 E MAIN ST, BRIDGEPORT, CT 06608-1913
(802) 233-1490
Mailing address
982 E MAIN ST, BRIDGEPORT, CT 06608-1913
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5819
CT
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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