Provider Demographics
NPI:1760468235
Name:MCCALL, CHRISTINE T (MSN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:T
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43 SMITH RD
Mailing Address - Street 2:ATTN PROFESSIONAL AFFAIRS
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02841-1006
Mailing Address - Country:US
Mailing Address - Phone:401-841-4522
Mailing Address - Fax:401-841-4128
Practice Address - Street 1:1 AYERS CIR
Practice Address - Street 2:BLDG H 1
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3892
Practice Address - Country:US
Practice Address - Phone:207-438-1130
Practice Address - Fax:207-438-2438
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MER030029363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN