Provider Demographics
NPI:1598711780
Name:RAUCCI, CHRISTINE DALE (APRN-BC, CNS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DALE
Last Name:RAUCCI
Suffix:
Gender:F
Credentials:APRN-BC, CNS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:85 CONSTITUTION LN
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3694
Mailing Address - Country:US
Mailing Address - Phone:978-750-0755
Mailing Address - Fax:978-750-0766
Practice Address - Street 1:85 CONSTITUTION LN
Practice Address - Street 2:SUITE 300A
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3694
Practice Address - Country:US
Practice Address - Phone:978-750-0755
Practice Address - Fax:978-750-0766
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-10-17
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Provider Licenses
StateLicense IDTaxonomies
MA125049364SP0809X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2441OtherBC/BS NP PROVIDER
MAP06872Medicare UPIN
MARANP2441Medicare ID - Type UnspecifiedNURSE PRACTITIONER