Individual
MRS. SUSAN ELIZABETH DE GRUCHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
332 HANOVER ST, BOSTON, MA 02113-1901
(617) 643-8000
Mailing address
24 MEADOW HILL RD, SHREWSBURY, MA 01545-6325
(617) 939-6949
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
212417
MA
363LF0000X
Family Nurse Practitioner
Primary
212417
MA
Other
Enumeration date
11/09/2005
Last updated
11/07/2008
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