Healthcare Provider Details

I. General information

NPI: 1407921778
Provider Name (Legal Business Name): CHRISTINE HULBERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 VILLAGE SQ
CHELMSFORD MA
01824-2712
US

IV. Provider business mailing address

3 VILLAGE SQ
CHELMSFORD MA
01824-2712
US

V. Phone/Fax

Practice location:
  • Phone: 978-256-4151
  • Fax: 978-256-3987
Mailing address:
  • Phone: 978-256-4151
  • Fax: 978-256-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberAP2262
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: