person
Kettly Cassamajor
Family Nurse Practitioner in Bridgeport, Connecticut
NPI 1235660267

Kettly Cassamajor is a Family Nurse Practitioner based in Wethersfield, CT and is specialized in Family. Kettly Cassamajor practices in Bridgeport, CT. The NPI Number for Kettly Cassamajor is 1235660267 and holds a License No. 12.006973 (Connecticut).

The current practice location address for Kettly Cassamajor is 4920 Main St Ste 302, Bridgeport, CT and can be reached out via phone at 475-210-4960 and via fax at 203-371-0542.

Location: 4920 Main St Ste 302, Bridgeport, CT, 06109-4337
person
Provider Profile Details
NPI Number
1235660267
Provider Name
Kettly Cassamajor
Credential
Provider Entity Type
Individual
Gender
Female
Address
4920 Main St Ste 302, Bridgeport, CT, 06109-4337
Phone Number
475-210-4960
Fax Number
203-371-0542
Provider Enumeration Date
03/22/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004234788 05 CT
institution
Provider Business Practice Location Address Details
Address
4920 Main St Ste 302
City
State
Zip
06606-1300
Phone Number
475-210-4960
Fax Number
203-371-0542
person
Provider Business Mailing Address Details
Address
4920 Main St Ste 302
City
State
Zip
06606-1300
Phone Number
475-210-4960
Fax Number
203-371-0542
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
12.006973 (Connecticut)
Definition
Definition to come...
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