Healthcare Provider Details

I. General information

NPI: 1982889986
Provider Name (Legal Business Name): CHRISTEN M ANDERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SECOND AVE
WALTHAM MA
02451-1158
US

IV. Provider business mailing address

132 DOVER ST
MEDFORD MA
02155-2322
US

V. Phone/Fax

Practice location:
  • Phone: 781-434-6500
  • Fax:
Mailing address:
  • Phone: 781-866-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number264611
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: