Provider Demographics
NPI:1518015387
Name:WHELAN, CHRISTINE GAIL (NNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:GAIL
Last Name:WHELAN
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CRESCI BLVD
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1133
Mailing Address - Country:US
Mailing Address - Phone:732-264-9331
Mailing Address - Fax:
Practice Address - Street 1:255 3RD AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6214
Practice Address - Country:US
Practice Address - Phone:732-923-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08004100363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care