Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 001296 | CT |
N | 363LG0600X | Nurse Practitioner - Gerontology | 001296 | CT |
NPI | 1033178926 |
---|---|
Provider Name | Mrs. Cynthia D L'heureux |
First Address | Griswold, CT 06351-1614 |
Second Address | Groton, CT 06340-3216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 04/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000 | (05) | CT |
P18617 | (02) | CT |