Provider Demographics
NPI:1164001418
Name:PROULX, CHRISTINA M (DNP, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:PROULX
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1873 S BELLAIRE ST STE 620
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4353
Mailing Address - Country:US
Mailing Address - Phone:720-263-6290
Mailing Address - Fax:
Practice Address - Street 1:1873 S BELLAIRE ST STE 620
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4353
Practice Address - Country:US
Practice Address - Phone:720-263-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996018363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty