Individual
MS. HEATHER LYNN CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5691
(860) 224-5795
Mailing address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5691
(860) 224-5795
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001750
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001750
LICENSE
CT
Enumeration date
01/30/2006
Last updated
09/09/2022
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