Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 9082 | CT |
NPI | 1265042881 |
---|---|
Provider Name | Taylor Nicole Vetrano |
First Address | Glastonbury, CT 06033-2379 |
Second Address | New Haven, CT 06510-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2020 |
Last Update Date | 07/08/2020 |