Provider Demographics
NPI:1346565959
Name:FIELDSON, CHRISTINE LAVERN (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LAVERN
Last Name:FIELDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 632
Mailing Address - Street 2:
Mailing Address - City:FORT MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:10922-0632
Mailing Address - Country:US
Mailing Address - Phone:845-446-2473
Mailing Address - Fax:845-446-2473
Practice Address - Street 1:100 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:10922
Practice Address - Country:US
Practice Address - Phone:845-947-6000
Practice Address - Fax:845-947-6141
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444980-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse