Provider Demographics
NPI:1689003386
Name:WERTZ, CHRISTINE (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:WERTZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEEHAN LN
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1413
Mailing Address - Country:US
Mailing Address - Phone:401-658-2525
Mailing Address - Fax:
Practice Address - Street 1:2 MEEHAN LN
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1413
Practice Address - Country:US
Practice Address - Phone:401-658-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278306363LP0200X
CT104797163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics