Healthcare Provider Details

I. General information

NPI: 1134426406
Provider Name (Legal Business Name): NICOLE A. DRURY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MOORELAND ST
SPRINGFIELD MA
01104-1826
US

IV. Provider business mailing address

147 NORMAN ST
WEST SPRINGFIELD MA
01089-5003
US

V. Phone/Fax

Practice location:
  • Phone: 413-785-5851
  • Fax: 413-785-5854
Mailing address:
  • Phone: 413-736-8329
  • Fax: 413-732-5362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: