Provider Demographics
NPI:1386324937
Name:LANPHERE, CHRISTIAN MICHAEL (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:LANPHERE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GRACE RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-5947
Mailing Address - Country:US
Mailing Address - Phone:617-308-0396
Mailing Address - Fax:
Practice Address - Street 1:17 GRACE RD
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5947
Practice Address - Country:US
Practice Address - Phone:617-308-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2329210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily