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NPI Code Detail

MEDICARE: CHRISTINE R CROSSON APRN

MEDICARE: CHRISTINE R CROSSON APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner000743CT

General Provider Information

NPI Number : 1992892319
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE R CROSSON APRN
Provider Business Mailing Address
First Line : 41 FAIR HARBOUR PL
Second Line :
City : NEW LONDON
State : CT
Zip : 06320-4710
Country : US
Telephone Number : 860-669-9014
Fax Number :
Provider Business Practice Location Address
First Line : 263 MAIN ST
Second Line : STE 304
City : OLD SAYBROOK
State : CT
Zip : 06475-2326
Country : US
Telephone Number : 860-395-6671
Fax Number : 860-395-6671
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 07/08/2007

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