Provider Demographics
NPI:1285750463
Name:ANDERSON, CHRISTINE JUDITH (NP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:JUDITH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:31 ELMBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1846
Mailing Address - Country:US
Mailing Address - Phone:781-276-7810
Mailing Address - Fax:
Practice Address - Street 1:295 VARNUM AVE
Practice Address - Street 2:RIVERSIDE PRIMARY CARE IPA
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2134
Practice Address - Country:US
Practice Address - Phone:978-452-4100
Practice Address - Fax:978-452-4100
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA213840363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology