Provider Demographics
NPI:1215812201
Name:GAGNE ARCHAMBEAULT, CHRISTINE ANN (PMHNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:GAGNE ARCHAMBEAULT
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2139
Mailing Address - Country:US
Mailing Address - Phone:518-488-9677
Mailing Address - Fax:
Practice Address - Street 1:501 NEW KARNER RD STE 9
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3882
Practice Address - Country:US
Practice Address - Phone:518-456-3614
Practice Address - Fax:518-456-3689
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF407432363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health