Individual provider · Type 1 NPI
Mary Ellen Lydem, APRN
Adult Health Nurse Practitioner · Bethel, CT
NPI number
1255514758
Active
Practice location
4 Berkshire Blvd
Bethel, CT 06801-1001
Fax (203) 775-6810
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 001563 (CT) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1255514758
Mary Ellen Lydem, APRN's National Provider Identifier is 1255514758, issued on Dec 7, 2007. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Bethel, CT. The record was last updated on Dec 7, 2007.