Healthcare Provider Details

I. General information

NPI: 1285258673
Provider Name (Legal Business Name): CRISTINA BOISVERT DNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

1110 DURHAM RD
MADISON CT
06443-1858
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9650
  • Fax: 860-545-9214
Mailing address:
  • Phone: 203-421-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8950
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8950
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: