Provider Demographics
NPI:1447382403
Name:GOSSELIN, CHRISTINE ANN (APRN CS (RN PC))
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANN
Last Name:GOSSELIN
Suffix:
Gender:F
Credentials:APRN CS (RN PC)
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:42 WASHINGTON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1803
Mailing Address - Country:US
Mailing Address - Phone:781-431-2629
Mailing Address - Fax:781-416-4321
Practice Address - Street 1:42 WASHINGTON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-1803
Practice Address - Country:US
Practice Address - Phone:781-431-2629
Practice Address - Fax:781-416-4321
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA134107163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAGONSO348Medicare ID - Type Unspecified