Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 024610 | CT |
NPI | 1023025525 |
---|---|
Provider Name | Brenda Nurse |
First Address | New Britain, CT 06053-2266 |
Second Address | New Britain, CT 06053-2266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B83594 | (02) | CT |