Healthcare Provider Details

I. General information

NPI: 1083022271
Provider Name (Legal Business Name): CATHERINE CROFOOT AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 DERRY RD
HUDSON NH
03051-3020
US

IV. Provider business mailing address

323 DERRY RD
HUDSON NH
03051-3020
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-3399
  • Fax:
Mailing address:
  • Phone: 347-563-0038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2277861
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: