Provider Demographics
NPI:1538600721
Name:ELIE, CHRISTINE ANN (LPN)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:ANN
Last Name:ELIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MARSHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-3316
Mailing Address - Country:US
Mailing Address - Phone:978-641-9693
Mailing Address - Fax:
Practice Address - Street 1:133 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1703
Practice Address - Country:US
Practice Address - Phone:617-350-0080
Practice Address - Fax:617-457-8175
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN62392164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse