Provider Demographics
NPI:1710522404
Name:ETHIER, CHRISTINE BARBARA (BSN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:BARBARA
Last Name:ETHIER
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1447
Mailing Address - Country:US
Mailing Address - Phone:978-888-1246
Mailing Address - Fax:
Practice Address - Street 1:275 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1447
Practice Address - Country:US
Practice Address - Phone:978-888-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-17
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA279319163W00000X
MARN279319163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse