Individual
CASEY ANNE MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-8722
Mailing address
417 E 5TH ST, BOSTON, MA 02127-3044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2307164
MA
363LF0000X
Family Nurse Practitioner
RN2307164
MA
Other
Enumeration date
07/26/2017
Last updated
11/09/2022
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