Individual
JESSICA LACROIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 323-7700
(617) 726-2000
Mailing address
4 RIDGE ST, MILLIS, MA 02054-1108
(508) 314-3111
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN2313652
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
AG11210088
MA
Other
Enumeration date
05/18/2017
Last updated
12/30/2021
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