Healthcare Provider Details
I. General information
NPI: 1902670599
Provider Name (Legal Business Name): CHRISTINA NICOLE LATORRA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2023
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3300 MAIN ST
SPRINGFIELD MA
01107-1112
US
IV. Provider business mailing address
3300 MAIN ST 3C &3D
SPRINGFIELD MA
01199
US
V. Phone/Fax
- Phone: 413-794-5600
- Fax: 413-794-7297
- Phone: 413-794-5600
- Fax: 413-794-7297
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 012897 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: