Healthcare Provider Details

I. General information

NPI: 1508575655
Provider Name (Legal Business Name): VANESSA CRESPO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 OLD ROAD TO 9 ACRE COR
CONCORD MA
01742-4181
US

IV. Provider business mailing address

56 BRITTANY LN
FITCHBURG MA
01420-8904
US

V. Phone/Fax

Practice location:
  • Phone: 978-371-1396
  • Fax:
Mailing address:
  • Phone: 978-340-0031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberRN2288195
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2288195
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN2288195
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: