Provider Demographics
NPI:1538143789
Name:SHOUKRY, CRISTINA LILIA (FNP)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:LILIA
Last Name:SHOUKRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4604
Mailing Address - Country:US
Mailing Address - Phone:760-520-8200
Mailing Address - Fax:760-737-7898
Practice Address - Street 1:1001 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4604
Practice Address - Country:US
Practice Address - Phone:760-520-8200
Practice Address - Fax:760-737-7898
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP12310363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P94557Medicare UPIN