Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN2282404 | MA |
NPI | 1003361551 |
---|---|
Provider Name | Christine Elizabeth O'connor |
First Address | Boston, MA 02113-1901 |
Second Address | Boston, MA 02113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2016 |
Last Update Date | 29/05/2018 |