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MRS. KATHLEEN MARIE BANNON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
31 UNION ST, ROCKVILLE, CT 06066-3126
(860) 872-5170
(860) 872-5206
Mailing address
54 SAINT MORITZ CIR, WILLINGTON, CT 06279-2210
(860) 684-4396

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
002093
CT

Other

Enumeration date
03/07/2006
Last updated
07/08/2007
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