Individual
MS. NANCY WALLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3463
Mailing address
192 REED ST, STRATFORD, CT 06614-3525
(203) 521-3508
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
E40623
CT
Other
Enumeration date
07/22/2013
Last updated
07/23/2013
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