Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 004749 | CT |
NPI | 1043595127 |
---|---|
Provider Name | Laura Prior |
First Address | Wallingford, CT 06492-2360 |
Second Address | Meriden, CT 06451-2101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2011 |
Last Update Date | 25/04/2019 |