Healthcare Provider Details

I. General information

NPI: 1285642942
Provider Name (Legal Business Name): CHRISTINE R CYR N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CUMMINGS CTR STE 266T
BEVERLY MA
01915-6172
US

IV. Provider business mailing address

309 HEIGHTS AT CAPE ANN
GLOUCESTER MA
01930-5333
US

V. Phone/Fax

Practice location:
  • Phone: 978-921-1190
  • Fax: 978-927-3724
Mailing address:
  • Phone: 978-979-8668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number102772
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: