Individual
MS. DIANE ROSE CROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
600 BOND ST, BRIDGEPORT, CT 06610-2205
(203) 384-6505
Mailing address
9 OAKLAND DR, TRUMBULL, CT 06611-1909
(203) 459-2495
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2827
CT
363LF0000X
Family Nurse Practitioner
Primary
002827
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004257417
—
CT
Enumeration date
02/24/2006
Last updated
01/25/2013
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