Healthcare Provider Details

I. General information

NPI: 1689003386
Provider Name (Legal Business Name): CHRISTINE WERTZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE STURDEVANT NP

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NEWTON ST
SOUTHBOROUGH MA
01772-1215
US

IV. Provider business mailing address

5 NEPONSET ST MERCANTILE CENTER 12TH FLOOR
WORCESTER MA
01606-2714
US

V. Phone/Fax

Practice location:
  • Phone: 508-460-3100
  • Fax: 508-460-3180
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number104797
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2278306
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: