Provider Demographics
NPI:1255470464
Name:HACKMAN, CHRISTINA MARIE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:HACKMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3782 MARBLE CANYON CRESCENT
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:K1V 1P8
Mailing Address - Country:CA
Mailing Address - Phone:613-822-7044
Mailing Address - Fax:
Practice Address - Street 1:2 WRAMC ROOM 2J38
Practice Address - Street 2:6900 GEORGIA AVE. NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28089929A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered