Individual
MRS. GRACE ANN GOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 FRUIT ST, BIGELOW 1034, BOSTON, MA 02114-2621
(617) 724-3277
(617) 643-1384
Mailing address
55 FRUIT ST, BIGELOW 1034, BOSTON, MA 02114-2621
(617) 724-3277
(617) 643-1384
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
109082
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP3901
BLUE SHIELD
MA
Enumeration date
02/26/2007
Last updated
07/08/2007
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