Individual
KELLY M DEFOREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL SURGERY DEPT, HARTFORD, CT 06102
(860) 545-2840
Mailing address
POB 40,000 DEPT 634, HARTFORD HOSPITAL PROFESSIONAL SERVICES, HARTFORD, CT 06151-0634
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
063305
CT
363LA2100X
Acute Care Nurse Practitioner
Primary
003156
CT
Other
Enumeration date
05/11/2006
Last updated
03/03/2008
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