Provider Demographics
NPI:1184949612
Name:ORDWAY, CHRISTINE REYNHOLDS (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:REYNHOLDS
Last Name:ORDWAY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 DAMON RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1132
Mailing Address - Country:US
Mailing Address - Phone:339-933-2126
Mailing Address - Fax:
Practice Address - Street 1:1253 WORCESTER RD STE 404
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5208
Practice Address - Country:US
Practice Address - Phone:508-488-4075
Practice Address - Fax:508-488-9129
Is Sole Proprietor?:No
Enumeration Date:2010-03-27
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN280870363LA2200X, 363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11086786AMedicaid