Provider Demographics
NPI:1598791865
Name:POPKIE, CHRISTINE RAE (RN, BSN,MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:RAE
Last Name:POPKIE
Suffix:
Gender:F
Credentials:RN, BSN,MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16280 DRESDEN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9024
Mailing Address - Country:US
Mailing Address - Phone:724-773-1995
Mailing Address - Fax:330-385-5463
Practice Address - Street 1:16280 DRESDEN AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9024
Practice Address - Country:US
Practice Address - Phone:724-773-1995
Practice Address - Fax:330-385-5463
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08844363L00000X
WV24876363L00000X
PASP009840363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner