Provider Demographics
NPI:1528032778
Name:LONDON, CHRISTINE BURKE (CNM)
Entity Type:Individual
Prefix:PROF
First Name:CHRISTINE
Middle Name:BURKE
Last Name:LONDON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HALKET ST
Mailing Address - Street 2:SUITE 2232
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3108
Mailing Address - Country:US
Mailing Address - Phone:412-641-4220
Mailing Address - Fax:
Practice Address - Street 1:300 HALKET ST
Practice Address - Street 2:SUITE 2232
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3108
Practice Address - Country:US
Practice Address - Phone:412-641-4220
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008518L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA058319D5LMedicare ID - Type Unspecified
PAP59785Medicare UPIN