Provider Demographics
NPI:1497892293
Name:DIGREGORIO, CHRISTINE MARY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARY
Last Name:DIGREGORIO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TANNERY RD
Mailing Address - Street 2:
Mailing Address - City:FISKDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01518-1170
Mailing Address - Country:US
Mailing Address - Phone:508-347-0825
Mailing Address - Fax:
Practice Address - Street 1:405 GROVE ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1270
Practice Address - Country:US
Practice Address - Phone:508-753-0800
Practice Address - Fax:508-438-0062
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213295363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3874OtherBCBS