Provider Demographics
NPI:1053116970
Name:BOUBOULIS, CHRISTINA MARIA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIA
Last Name:BOUBOULIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3825
Mailing Address - Country:US
Mailing Address - Phone:617-888-9601
Mailing Address - Fax:
Practice Address - Street 1:5 WELLINGTON RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-3825
Practice Address - Country:US
Practice Address - Phone:617-888-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2342517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily