Provider Demographics
NPI:1689624603
Name:WATLER, CHRISTINE I (ARNP - NNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:I
Last Name:WATLER
Suffix:
Gender:F
Credentials:ARNP - NNP
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:I
Other - Last Name:HATKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:22 BRAMHALL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3134
Mailing Address - Country:US
Mailing Address - Phone:207-662-2273
Mailing Address - Fax:207-662-6324
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3134
Practice Address - Country:US
Practice Address - Phone:207-662-2273
Practice Address - Fax:207-662-6324
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1652532363LN0005X
MECNP151178363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA678524187AMedicaid
FL3020274-00Medicaid
FL3020274-00Medicaid
FLY0637XMedicare PIN
FLY0637YMedicare PIN