Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | R21615 | CT |
NPI | 1023100799 |
---|---|
Provider Name | Ms. Lesley Grace Woods Solkoske |
First Address | Meriden, CT 06450-7433 |
Second Address | Hartford, CT 06105-1208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |