SUSADA INTHAVONG, APRN

Nurse Practitioner

Active Individual
NPI: 1275770398

Practice Address

1504 SULLIVAN AVE
South Windsor, CT 06074

Phone: (860) 644-1523

Specialties

Specialty Code Primary License
Nurse Practitioner 363L00000X Yes 003968 (CT)

Frequently Asked Questions

NPI 1275770398 is the National Provider Identifier for SUSADA INTHAVONG, APRN, a Nurse Practitioner provider located in South Windsor, CT. This NPI was enumerated on January 12, 2009.
SUSADA INTHAVONG, APRN practices at 1504 SULLIVAN AVE, South Windsor, CT 06074.

Quick Facts

NPI
1275770398
Type
Individual
Enumerated
Jan 12, 2009
Last Updated
Jan 12, 2009

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