Individual
ASHLEY BROOKE DECICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
100 CAMBRIDGE ST, BOSTON, MA 02114-2509
(617) 726-4121
Mailing address
100 CAMBRIDGE ST, BOSTON, MA 02114-2509
(617) 726-4121
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN2304195
MA
363L00000X
Nurse Practitioner
Primary
RN2304195
MA
Other
Enumeration date
07/29/2021
Last updated
05/10/2022
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