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Jung Mi De Thouars
Family Nurse Practitioner in Willimantic, Connecticut
NPI 1699239293

Jung Mi De Thouars is a Family Nurse Practitioner based in Henrico, CT and is specialized in Family. Jung Mi De Thouars practices in Willimantic, CT. The NPI Number for Jung Mi De Thouars is 1699239293 and holds a License No. 138693 (Connecticut).

The current practice location address for Jung Mi De Thouars is 40 Mansfield Ave, Willimantic, CT and can be reached out via phone at 860-450-7471.

Location: 40 Mansfield Ave, Willimantic, CT, 23233-6606
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699239293
Provider Name
Jung Mi De Thouars
Credential
Provider Entity Type
Individual
Gender
Female
Address
40 Mansfield Ave, Willimantic, CT, 23233-6606
Phone Number
860-450-7471
Fax Number
Provider Enumeration Date
01/28/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
138693 05 CT
institution
Provider Business Practice Location Address Details
Address
40 Mansfield Ave
City
Willimantic
State
Connecticut
Zip
06226-2018
Phone Number
860-450-7471
Fax Number
person
Provider Business Mailing Address Details
Address
40 Mansfield Ave
City
Willimantic
State
Connecticut
Zip
06226-2018
Phone Number
860-450-7471
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
138693 (Connecticut)
Definition
Definition to come...
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