Individual
NICOLE D PUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-4123
Mailing address
931 GOSHEN HILL RD EXT, LEBANON, CT 06249-2301
(661) 706-6546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10008
CT
363LF0000X
Family Nurse Practitioner
53-79632-032
KS
363LF0000X
Family Nurse Practitioner
95014789
CA
Other
Enumeration date
08/26/2020
Last updated
11/29/2023
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