Individual
MS. CATHERINE G MICINILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7003 MAIN ST, STRATFORD, CT 06614
(203) 257-6647
Mailing address
30 INVERNESS RD, TRUMBULL, CT 06611-1716
(203) 257-6647
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
001098
CT
363LP0200X
Pediatric Nurse Practitioner
001098
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001098
CT APRN LICENCE
CT
Enumeration date
10/04/2006
Last updated
12/13/2018
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