Individual
MRS. COURTNEY WILSON DEFUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 FRUIT ST, BIGELOW 800, BOSTON, MA 02114-2621
(617) 726-2256
Mailing address
55 FRUIT ST, BIGELOW 800, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN281678
MA
Other
Enumeration date
12/24/2013
Last updated
01/06/2016
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