Healthcare Provider Details

I. General information

NPI: 1639611320
Provider Name (Legal Business Name): CHRISTOPHER CAULFIELD CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 S WASHINGTON ST
NORTH ATTLEBORO MA
02760-2129
US

IV. Provider business mailing address

90 BYNNER ST APT A
JAMAICA PLAIN MA
02130-1001
US

V. Phone/Fax

Practice location:
  • Phone: 508-316-0725
  • Fax:
Mailing address:
  • Phone: 508-212-1077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2270943
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: