Individual
CHRISTINE LUPA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
25 HIGHLAND AVE, NEWBURYPORT, MA 01950-3867
(978) 463-1050
Mailing address
60 RABBIT RD, SALISBURY, MA 01952-1824
(978) 465-2453
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
138593
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP1484
BCBS
MA
Enumeration date
04/03/2006
Last updated
04/18/2008
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