Individual
REBECCA MENNILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11 GREEN HILL RD, ORANGE, CT 06477-1211
(203) 804-5821
Mailing address
11 GREEN HILL RD, ORANGE, CT 06477-1211
(203) 804-5821
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
68845
CT
363LF0000X
Family Nurse Practitioner
Primary
68845
CT
Other
Enumeration date
07/28/2022
Last updated
02/06/2025
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