Organization
HEADACHE CARE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRETCHEN T. MICHAELSON APRN (APRN)
(860) 263-3603
Entity
Organization
Contact information
Practice address
1741 ELLINGTON RD STE 1, SOUTH WINDSOR, CT 06074-2720
(860) 263-3603
Mailing address
185 PIERCE RD, SOUTH WINDSOR, CT 06074-2633
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
003107
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500001383
—
CT
Enumeration date
04/03/2018
Last updated
04/03/2018
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