Provider Demographics
NPI:1639393374
Name:WALDRON, CRISTINE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CRISTINE
Middle Name:
Last Name:WALDRON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLUE HILLS MEDICAL ASSOCIATES
Mailing Address - Street 2:340 WOOD ROAD SUITE 203
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184
Mailing Address - Country:US
Mailing Address - Phone:781-849-1111
Mailing Address - Fax:781-794-2280
Practice Address - Street 1:BLUE HILLS MEDICAL ASSOCIATES
Practice Address - Street 2:340 WOOD ROAD SUITE 203
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184
Practice Address - Country:US
Practice Address - Phone:781-849-1111
Practice Address - Fax:781-794-2280
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197680363LA2200X, 363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMW0856938OtherDEA