Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 000339 | CT |
NPI | 1003931759 |
---|---|
Provider Name | Ms. Judith H Dessel |
First Address | Storrs, CT 06269-2011 |
Second Address | Storrs, CT 06269-2011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |