Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 8383 | CT |
NPI | 1033764550 |
---|---|
Provider Name | Anna Lorraine North |
First Address | Hartford, CT 06105-1001 |
Second Address | Hartford, CT 06105-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2019 |
Last Update Date | 12/08/2019 |