Provider Demographics
NPI:1093940629
Name:NEVIN, CHRIS DAVIES (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRIS
Middle Name:DAVIES
Last Name:NEVIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:CHRIS
Other - Middle Name:DAVIES
Other - Last Name:FANTRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:55 OID NYACK TURNPIKE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954
Mailing Address - Country:US
Mailing Address - Phone:845-624-3882
Mailing Address - Fax:845-624-3992
Practice Address - Street 1:55 OID NYACK TURNPIKE
Practice Address - Street 2:SUITE 401
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954
Practice Address - Country:US
Practice Address - Phone:845-624-3882
Practice Address - Fax:845-624-3992
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333165363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner