Individual
KATHLEEN R BONAVENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1305 POST RD, FAIRFIELD, CT 06824-6016
(203) 292-2000
(203) 255-5212
Mailing address
103 THOREAU DR, SHELTON, CT 06484-1638
(203) 292-2000
(203) 255-5212
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
002078
CT
Other
Enumeration date
02/14/2006
Last updated
03/15/2010
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