Provider Demographics
NPI:1063037406
Name:WAITE, CHRISSY-ANN
Entity Type:Individual
Prefix:
First Name:CHRISSY-ANN
Middle Name:
Last Name:WAITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 293
Mailing Address - Street 2:
Mailing Address - City:GILMANTON IW
Mailing Address - State:NH
Mailing Address - Zip Code:03837-0293
Mailing Address - Country:US
Mailing Address - Phone:603-892-8896
Mailing Address - Fax:
Practice Address - Street 1:347 STAGE RD
Practice Address - Street 2:
Practice Address - City:GILMANTON IW
Practice Address - State:NH
Practice Address - Zip Code:03837-5630
Practice Address - Country:US
Practice Address - Phone:603-409-7095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide