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Individual

MARA SHAW WHITMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
147 WESTBROOK RD, ESSEX, CT 06426-1512
(860) 358-5065
Mailing address
147 WESTBROOK RD, ESSEX, CT 06426-1512
(860) 358-5065

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164048
CT
363L00000X
Nurse Practitioner
Primary
11614
CT

Other

Enumeration date
01/05/2023
Last updated
02/11/2023
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