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1922510536
LISA MA PROVERA
HARTFORD, CT
NPI
1922510536
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CT 122606)
Enumeration Date
2017-11-05
Last Update Date
2017-11-05
Business Address
LISA MA PROVERA
43 WOODLAND ST
HARTFORD, CT 06105-2363
Phone number: 888-793-3500
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Mailing Address
LISA MA PROVERA
91 FALKNOR DR
MANCHESTER, CT 06040-2642
Phone number: 860-961-9558
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