| NPI | 1265892541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARIE SWAN Owner 860-325-2679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2024-08-02 |