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1770589921
MARY G KINAHAN
FARMINGTON, CT
NPI
1770589921
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CT 001338)
Enumeration Date
2005-06-22
Last Update Date
2014-04-14
Business Address
-- MARY G KINAHAN APRN
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-4477
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Mailing Address
-- MARY G KINAHAN APRN
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
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