Susada Inthavong, APRN
NPI #1275770398 in South Windsor, Connecticut
Provider Information
- NPI Number
- 1275770398
- Entity Type
- Individual
- Name
- Susada Inthavong, APRN
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- APRN
- Enumeration Date
- Jan 12, 2009
- Last Updated
- Jan 12, 2009
Practice Location
- Address
- 1504 SULLIVAN AVE
- City
- South Windsor
- State
- Connecticut
- ZIP Code
- 06074-2711
- Phone
- (860) 644-1523
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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