Individual
CHANDEL MARIE BOUTHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
164 MOUNT PLEASANT RD STE 202, NEWTOWN, CT 06470-1477
(203) 270-1016
Mailing address
5231 AVALON DR W, ORANGE, CT 06477-3677
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12091
CT
Other
Enumeration date
06/23/2023
Last updated
01/26/2024
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