Provider Demographics
NPI:1083313845
Name:MCKENNA-LEZZO, CHRISTINA (APN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MCKENNA-LEZZO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 NJ-88 #202
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-4007
Mailing Address - Country:US
Mailing Address - Phone:732-604-7448
Mailing Address - Fax:
Practice Address - Street 1:1640 NJ ROUTE 88
Practice Address - Street 2:UNIT 202
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724
Practice Address - Country:US
Practice Address - Phone:732-458-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNUR-2023-001753363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology