Individual
CHRISTINE COUPERUS-MASHEWSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4 COMMERCE LN, CANTON, NY 13617-3739
(315) 386-8191
(315) 386-1410
Mailing address
4 COMMERCE LN, CANTON, NY 13617-3739
(315) 386-8191
(315) 386-1410
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F-339655
NY
363LF0000X
Family Nurse Practitioner
Primary
F339655-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04207952
—
NY
Enumeration date
07/14/2015
Last updated
06/26/2019
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