Provider Demographics
NPI:1649293911
Name:BOOTH, CHRISTINE P (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:P
Last Name:BOOTH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 54TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-1417
Mailing Address - Country:US
Mailing Address - Phone:978-462-1873
Mailing Address - Fax:
Practice Address - Street 1:75 SYLVAN ST
Practice Address - Street 2:SUITE B-102
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2740
Practice Address - Country:US
Practice Address - Phone:978-774-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0531032312163W00000X
NH053103-23-12363LA2100X
MA177115363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care