NPI Code Details Logo

NPI 1689003386

NPI 1689003386 : CHRISTINE WERTZ APRN : SOUTHBOROUGH, MA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1689003386
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CHRISTINE WERTZ APRN
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/04/2013
-----------------------------------------------------
    Last Update Date     |    09/04/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    24 NEWTON ST 
-----------------------------------------------------
    City                 |    SOUTHBOROUGH
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    01772-1215
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    508-460-3100
-----------------------------------------------------
    Fax                  |    508-460-3180
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5 NEPONSET ST MERCANTILE CENTER 12TH FLOOR
-----------------------------------------------------
    City                 |    WORCESTER
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    01606-2714
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    163W00000X
-----------------------------------------------------
    Taxonomy Name        |    Registered Nurse
-----------------------------------------------------
    License Number       |    104797
-----------------------------------------------------
    License Number State |    CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363LP0200X
-----------------------------------------------------
    Taxonomy Name        |    Pediatric Nurse Practitioner
-----------------------------------------------------
    License Number       |    RN2278306
-----------------------------------------------------
    License Number State |    MA
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.