Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 7705 | CT |
NPI | 1023595147 |
---|---|
Provider Name | Mr. Nigel Rodney |
First Address | West Hartford, CT 06110-1643 |
Second Address | Hartford, CT 06106-1541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2018 |
Last Update Date | 21/07/2018 |