Provider Demographics
NPI:1477953404
Name:CHAMPION, CHRISTIE JM (MSN,AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:JM
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:MSN,AGACNP-BC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:100 MCGREGOR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3730
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 RESEARCH PL
Practice Address - Street 2:
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2460
Practice Address - Country:US
Practice Address - Phone:978-256-6607
Practice Address - Fax:978-250-8189
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH067559-23363L00000X
MARN276202363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner