Individual
EILEEN CRUTCHLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376
Mailing address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001280
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001280
STATE LICENSE
CT
Enumeration date
04/04/2007
Last updated
07/08/2007
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