Individual
PRISCILLA STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1425 BLUE HILL AVE, MATTAPAN, MA 02126-2253
(617) 898-9045
(617) 296-1421
Mailing address
1425 BLUE HILL AVE, MATTAPAN, MA 02126-2253
(617) 898-9045
(617) 296-1421
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
278147
MA
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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