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Individual

LISA HAUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
227 MAIN ST, TORRINGTON, CT 06790-5202
(860) 618-5455
(860) 618-2530
Mailing address
227 MAIN ST, TORRINGTON, CT 06790-5202
(860) 618-5455
(860) 618-2530

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
001512
CT
363LF0000X
Family Nurse Practitioner
Primary
001512
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0015123630
CONNECTICARE
CT
01
787904
MVP
CT
01
90350
GHI
CT
Enumeration date
07/12/2005
Last updated
01/25/2019
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