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NPI Code Detail

MEDICARE: TAYLOR CHRISTINE PUDDISTER

MEDICARE: TAYLOR CHRISTINE PUDDISTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse068379-21NH
2163W00000XRegistered NurseRN2288813MA
3363LA2100XAcute Care Nurse Practitioner068379-23NH
4363LA2100XAcute Care Nurse PractitionerRN2288813MA
5363L00000XNurse PractitionerRN2288813MA

General Provider Information

NPI Number : 1659824209
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR CHRISTINE PUDDISTER
Provider Business Mailing Address
First Line : 50 DOLPHIN RD
Second Line :
City : NEWTON
State : MA
Zip : 02459-1305
Country : US
Telephone Number : 617-290-4245
Fax Number :
Provider Business Practice Location Address
First Line : 145 WARD HILL AVE
Second Line :
City : HAVERHILL
State : MA
Zip : 01835-6928
Country : US
Telephone Number : 978-372-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2016
Last Update Date : 12/30/2020

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Directions to “ TAYLOR CHRISTINE PUDDISTER ” Practice Location

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