Individual
DRUCILLA BACON
Active
Individual
DRUCILLA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-13312
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066886
—
OH
01
—
0091231
PARTNERS PHYSICIAN GROUP MEDICAID GROUP # URGENT CARE
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
1992138028
PARTNERS PHYSICIAN GROUP TYPE 2 NPI # URGENT CARE
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
02/13/2012
Last updated
03/17/2015
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