Individual provider · Type 1 NPI
Susada Inthavong, APRN
Nurse Practitioner · South Windsor, CT
Practice location
1504 Sullivan Ave
South Windsor, CT 06074-2711
Fax (860) 648-9468
Mailing address
29 Naek Rd, Suite 5
Vernon, CT 06066-3942
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 003968 (CT) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1275770398
Susada Inthavong, APRN's National Provider Identifier is 1275770398, issued on Jan 12, 2009. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in South Windsor, CT. The record was last updated on Jan 12, 2009.