Healthcare Provider Details

I. General information

NPI: 1447382403
Provider Name (Legal Business Name): CHRISTINE ANN GOSSELIN APRN CS (RN PC)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 WASHINGTON ST SUITE 210
WELLESLEY MA
02481-1803
US

IV. Provider business mailing address

42 WASHINGTON ST SUITE 210
WELLESLEY MA
02481-1803
US

V. Phone/Fax

Practice location:
  • Phone: 781-431-2629
  • Fax: 781-416-4321
Mailing address:
  • Phone: 781-431-2629
  • Fax: 781-416-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number134107
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: