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1689003386 NPI number — CHRISTINE WERTZ APRN

NPI Number: 1689003386
Health Care Provider/Practitioner: CHRISTINE WERTZ APRN

Information about “1689003386” NPI (CHRISTINE WERTZ APRN) exists in 1689003386 in HTML format HTML  |  1689003386 in plain Text format TXT  |  1689003386 in PDF (Portable Document Format) PDF  |  1689003386 in an XML format XML  formats.

NPI Number : 1689003386 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689003386",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WERTZ",
    "FirstName": "CHRISTINE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STURDEVANT",
    "OtherFirstName": "CHRISTINE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5 NEPONSET ST",
    "SecondLineMailingAddress": "MERCANTILE CENTER 12TH FLOOR",
    "MailingAddressCityName": "WORCESTER",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01606-2714",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "24 NEWTON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SOUTHBOROUGH",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01772-1215",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "508-460-3100",
    "PracticeLocationAddressFaxNumber": "508-460-3180",
    "EnumerationDate": "11/04/2013",
    "LastUpdateDate": "09/04/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "104797",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LP0200X",
          "TaxonomyName": "Pediatric Nurse Practitioner",
          "LicenseNumber": "RN2278306",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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