Healthcare Provider Details

I. General information

NPI: 1760468235
Provider Name (Legal Business Name): CHRISTINE T MCCALL MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AYERS CIR BLDG H 1
PORTSMOUTH NH
03801-3892
US

IV. Provider business mailing address

43 SMITH RD ATTN PROFESSIONAL AFFAIRS
NEWPORT RI
02841-1006
US

V. Phone/Fax

Practice location:
  • Phone: 207-438-1130
  • Fax: 207-438-2438
Mailing address:
  • Phone: 401-841-4522
  • Fax: 401-841-4128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR030029
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: