Healthcare Provider Details

I. General information

NPI: 1871569905
Provider Name (Legal Business Name): CHRISTINE J REID MS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 11/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 MAIN ST SUITE 706A, BICKFORD HEALTH ASSOCIATES,PC
YARMOUTH PORT MA
02675-2000
US

IV. Provider business mailing address

714 MAIN ST SUITE 706A, BICKFORD HEALTH ASSOCIATES,PC
YARMOUTH PORT MA
02675-2000
US

V. Phone/Fax

Practice location:
  • Phone: 508-362-1600
  • Fax: 508-362-1616
Mailing address:
  • Phone: 508-362-1600
  • Fax: 508-362-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number111128
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: