Provider Demographics
NPI:1881666766
Name:STELLA, CHRISTINE M (DNP, ANP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:STELLA
Suffix:
Gender:F
Credentials:DNP, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:857-364-2692
Mailing Address - Fax:
Practice Address - Street 1:150 SOUTH HUNTINGTON AVE
Practice Address - Street 2:BOSTON VA HEALTHCARE SYSTEM
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:857-364-2692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218194363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP4784OtherBLUE CROSS
MANP4784Medicare ID - Type Unspecified
MANP4784OtherBLUE CROSS