Individual
ELLEN CONROY CROUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
11 WINFIELD ST, SOUTH BOSTON, MA 02127-4125
(617) 268-6084
Mailing address
49 FAIRBANKS ST, BRIGHTON, MA 02135-2503
(508) 789-1396
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
232708
MA
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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