Provider Demographics
NPI:1346526498
Name:WOOD, CHRISTINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-3210
Mailing Address - Country:US
Mailing Address - Phone:845-333-6500
Mailing Address - Fax:845-333-6501
Practice Address - Street 1:8881 STATE ROUTE 97
Practice Address - Street 2:
Practice Address - City:CALLICOON
Practice Address - State:NY
Practice Address - Zip Code:12723-5052
Practice Address - Country:US
Practice Address - Phone:845-333-6860
Practice Address - Fax:845-887-5694
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN562480163W00000X
NY542859-1163W00000X
NYF344598-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05739551Medicaid