Provider Demographics
NPI:1295104131
Name:COIMBRA, CHRISTINE E (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:COIMBRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090
Mailing Address - Country:US
Mailing Address - Phone:781-326-7700
Mailing Address - Fax:781-407-0097
Practice Address - Street 1:541 HIGH STREET
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090
Practice Address - Country:US
Practice Address - Phone:781-326-7700
Practice Address - Fax:781-407-0097
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2292154363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics