Provider Demographics
NPI:1922520360
Name:REPSHA, CHRISTINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:REPSHA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3883
Mailing Address - Country:US
Mailing Address - Phone:732-543-6995
Mailing Address - Fax:
Practice Address - Street 1:93 MAIN ST APT 1
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3883
Practice Address - Country:US
Practice Address - Phone:732-543-6995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily