Individual provider · Type 1 NPI

Kendra Moderow

Licensed Practical Nurse · Putnam, CT

NPI number 1760065064 Active

Practice location

391 Pomfret St
Putnam, CT 06260-1852

Call (860) 731-5522 Map

Fax (860) 731-5536

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1588

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X042247 (CT)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1760065064

Kendra Moderow's National Provider Identifier is 1760065064, issued on May 4, 2021. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Putnam, CT. The record was last updated on May 4, 2021.